Provider Demographics
NPI:1669487070
Name:HENCINSKI, MARY APFEL (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:APFEL
Last Name:HENCINSKI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:MARGARET
Other - Last Name:APFEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:30 BLUEBERRY RD
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:FL
Mailing Address - Zip Code:32439-3016
Mailing Address - Country:US
Mailing Address - Phone:850-835-4127
Mailing Address - Fax:850-835-7055
Practice Address - Street 1:30 BLUEBERRY RD
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:FL
Practice Address - Zip Code:32439-3016
Practice Address - Country:US
Practice Address - Phone:850-835-4127
Practice Address - Fax:850-835-7055
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN0010132122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist