Provider Demographics
NPI:1922287234
Name:MOHR, HENRY CLIFFORD (DDS)
Entity Type:Individual
Prefix:
First Name:HENRY
Middle Name:CLIFFORD
Last Name:MOHR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:899 N WILMOT RD STE E5
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-1717
Mailing Address - Country:US
Mailing Address - Phone:520-745-0126
Mailing Address - Fax:520-745-0706
Practice Address - Street 1:899 N WILMOT RD STE E5
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-1717
Practice Address - Country:US
Practice Address - Phone:520-745-0126
Practice Address - Fax:520-745-0706
Is Sole Proprietor?:No
Enumeration Date:2007-11-02
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1909122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist