Provider Demographics
NPI:1750773776
Name:HENRIOD AND PAPWORTH DENTAL CORPORATION
Entity type:Organization
Organization Name:HENRIOD AND PAPWORTH DENTAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HENRIOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-698-4426
Mailing Address - Street 1:40250 MURRIETA HOT SPRINGS RD
Mailing Address - Street 2:SUITE 119
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-4961
Mailing Address - Country:US
Mailing Address - Phone:951-698-4426
Mailing Address - Fax:951-698-7570
Practice Address - Street 1:40250 MURRIETA HOT SPRINGS RD
Practice Address - Street 2:SUITE 119
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-4961
Practice Address - Country:US
Practice Address - Phone:951-698-4426
Practice Address - Fax:951-698-7570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-27
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA551241223P0300X
CA398431223P0700X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty
No1223P0700XDental ProvidersDentistProsthodonticsGroup - Multi-Specialty