Provider Demographics
NPI:1942368881
Name:HENRY, K DANA (DDS)
Entity Type:Individual
Prefix:DR
First Name:K
Middle Name:DANA
Last Name:HENRY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5336 ESTATE OFFICE DRIVE
Mailing Address - Street 2:STE #1
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119
Mailing Address - Country:US
Mailing Address - Phone:901-681-0408
Mailing Address - Fax:901-681-9753
Practice Address - Street 1:5336 ESTATE OFFICE DRIVE
Practice Address - Street 2:STE #1
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119
Practice Address - Country:US
Practice Address - Phone:901-681-0408
Practice Address - Fax:901-681-9753
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS00007027122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist