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Individual
MITCHELL JAY HENRY
Active
Individual
MITCHELL JAY HENRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D., D.D.S.
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
5504
NE
174400000X
Specialist
Primary
18887
NE
Other
Enumeration date
10/24/2005
Last updated
09/11/2023
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