Provider Demographics
NPI:1801294103
Name:NATALIE E. HENKE, DDS, PLLC
Entity type:Organization
Organization Name:NATALIE E. HENKE, DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DDS/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:HENKE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:734-971-6400
Mailing Address - Street 1:2770 CARPENTER RD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-4104
Mailing Address - Country:US
Mailing Address - Phone:734-971-6400
Mailing Address - Fax:734-971-4427
Practice Address - Street 1:2770 CARPENTER RD
Practice Address - Street 2:SUITE 120
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-4104
Practice Address - Country:US
Practice Address - Phone:734-971-6400
Practice Address - Fax:734-971-4427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-18
Last Update Date:2014-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901017244261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental