Provider Demographics
NPI:1255341160
Name:STEARNS, HENRY C (DMD)
Entity type:Individual
Prefix:
First Name:HENRY
Middle Name:C
Last Name:STEARNS
Suffix:
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 1:805 HIGH ST NE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-2442
Mailing Address - Country:US
Mailing Address - Phone:503-378-1334
Mailing Address - Fax:503-581-9464
Practice Address - Street 1:805 HIGH ST NE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-2442
Practice Address - Country:US
Practice Address - Phone:503-378-1334
Practice Address - Fax:503-581-9464
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4881122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CX053OtherPACIFICARE INSURANCE