Provider Demographics
NPI:1912524737
Name:VANDERFIN, HENRY MERCER (DMD)
Entity Type:Individual
Prefix:
First Name:HENRY
Middle Name:MERCER
Last Name:VANDERFIN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:HANK
Other - Middle Name:MERCER
Other - Last Name:VANDERFIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8204 BUTLER RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845-4150
Mailing Address - Country:US
Mailing Address - Phone:805-729-8218
Mailing Address - Fax:
Practice Address - Street 1:3011 HIGHWAY 30 W
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:TX
Practice Address - Zip Code:77340-3534
Practice Address - Country:US
Practice Address - Phone:936-294-0400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-26
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37733122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty