Provider Demographics
NPI:1942369962
Name:CHENEY, HENRY G JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:G
Last Name:CHENEY
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 SPARHAWK ST
Mailing Address - Street 2:
Mailing Address - City:AMESBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01913-3317
Mailing Address - Country:US
Mailing Address - Phone:978-388-3505
Mailing Address - Fax:
Practice Address - Street 1:41 SPARHAWK ST
Practice Address - Street 2:
Practice Address - City:AMESBURY
Practice Address - State:MA
Practice Address - Zip Code:01913-3317
Practice Address - Country:US
Practice Address - Phone:978-388-3505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA166121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAX05950OtherBCBS PROVIDER ID