Provider Demographics
NPI:1902420292
Name:R. ASHER HENEGAR DDS
Entity Type:Organization
Organization Name:R. ASHER HENEGAR DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:REX
Authorized Official - Middle Name:ASHER
Authorized Official - Last Name:HENEGAR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:719-896-4256
Mailing Address - Street 1:1675 BRIARGATE BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-3416
Mailing Address - Country:US
Mailing Address - Phone:719-896-4256
Mailing Address - Fax:719-896-4818
Practice Address - Street 1:1675 BRIARGATE BLVD STE A
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-3416
Practice Address - Country:US
Practice Address - Phone:719-896-4256
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-02
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty