Provider Demographics
NPI:1679684070
Name:HENRY, CHRISTOPHER HANS (DMD MS PC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:HANS
Last Name:HENRY
Suffix:
Gender:M
Credentials:DMD MS PC
Other - Prefix:
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Mailing Address - Street 1:114 MINNIE ST
Mailing Address - Street 2:STE 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:STE 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
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AKAA10991223X0400X
AK10991223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Not Answered1223P0221XDental ProvidersDentistPediatric Dentistry