Provider Demographics
NPI:1972661049
Name:DUYZEND, HENRI FREDERIK
Entity Type:Individual
Prefix:DR
First Name:HENRI
Middle Name:FREDERIK
Last Name:DUYZEND
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18528 FIRLANDS WAY NORTH
Mailing Address - Street 2:SUITE C
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98133
Mailing Address - Country:US
Mailing Address - Phone:206-542-2192
Mailing Address - Fax:206-542-2192
Practice Address - Street 1:18528 FIRLANDS WAY NORTH
Practice Address - Street 2:SUITE C
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98133
Practice Address - Country:US
Practice Address - Phone:206-542-2192
Practice Address - Fax:206-542-2192
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
WADE00004919122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist