Individual
SHAINA IMMACULEE HENRIQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
271 WAVERLEY OAKS RD STE 101, WALTHAM, MA 02452-8475
(786) 506-4437
Mailing address
3611 WASHINGTON ST UNIT B232, JAMAICA PLAIN, MA 02130-2951
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN1858588
MA
Other
Enumeration date
06/01/2017
Last updated
08/12/2025
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