Provider Demographics
NPI:1952475261
Name:CRAIG A HENRY DDS
Entity Type:Organization
Organization Name:CRAIG A HENRY DDS
Other - Org Name:ALL SMILES ORTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER ORTHODONTIST
Authorized Official - Prefix:MR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:A
Authorized Official - Last Name:HENRY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:985-641-3440
Mailing Address - Street 1:2790 E GAUSE BLVD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70461
Mailing Address - Country:US
Mailing Address - Phone:985-641-3440
Mailing Address - Fax:985-641-3482
Practice Address - Street 1:2790 E GAUSE BLVD
Practice Address - Street 2:SUITE 3
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70461
Practice Address - Country:US
Practice Address - Phone:985-641-3440
Practice Address - Fax:985-641-3482
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA37811223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty