# AUBREY J HENSHAW III DDS PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Aesthetic Dental Institute
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205404399
- **Authorized official:** AUBREY J HENSHAW III DDS (DENTIST)
- **Authorized official phone:** (918) 775-4431

## Contact information

- **Practice address:** 611 W RUTH AVE, SALLISAW, OK 74955-6866
- **Practice address phone:** (918) 775-4431
- **Practice address fax:** (918) 775-4432
- **Mailing address:** PO BOX 708, SALLISAW, OK 74955-0708
- **Mailing address phone:** (918) 775-4431
- **Mailing address fax:** (918) 775-4432

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 06/15/2021
- **Last updated:** 06/15/2021