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Individual

BRAXTON HENDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
510 NICHOLAS RD STE F, GREENSBORO, NC 27409-3404
(252) 213-8484
Mailing address
316 MAIN ST, OXFORD, NC 27565-3323
(252) 213-8484

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
DS040743
PA
1223D0004X
Dental Anesthesiology
Primary
0401416381
VA
1223D0004X
Dental Anesthesiology
10942
NC

Other

Enumeration date
04/14/2016
Last updated
02/05/2019
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