Provider Demographics
NPI:1720086788
Name:HENRY, ROBERT JOSEPH (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JOSEPH
Last Name:HENRY
Suffix:
Gender:M
Credentials:DDS, MS
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Mailing Address - Street 1:2624 GRAND AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GLENWOOD SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:81601-4176
Mailing Address - Country:US
Mailing Address - Phone:970-928-9500
Mailing Address - Fax:970-928-7467
Practice Address - Street 1:2624 GRAND AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:GLENWOOD SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:81601-4176
Practice Address - Country:US
Practice Address - Phone:970-928-9500
Practice Address - Fax:970-928-7467
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO77341223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry