Provider Demographics
NPI:1649381047
Name:CHRISTOPHER H HENRY DMD MS PC
Entity Type:Organization
Organization Name:CHRISTOPHER H HENRY DMD MS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:HANS
Authorized Official - Last Name:HENRY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD MS PC
Authorized Official - Phone:907-457-7878
Mailing Address - Street 1:114 MINNIE ST
Mailing Address - Street 2:ST B
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99701
Mailing Address - Country:US
Mailing Address - Phone:907-457-7878
Mailing Address - Fax:907-457-4509
Practice Address - Street 1:114 MINNIE ST
Practice Address - Street 2:ST B
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701
Practice Address - Country:US
Practice Address - Phone:907-457-7878
Practice Address - Fax:907-457-4509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKAA10991223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty