Organization
RICHARD G. HENRY
Active
Other names
Valverde Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH P SPLAWN (BUSINESS ASSISTANT)
(580) 482-0441
Entity
Organization
Contact information
Practice address
112 VAL VERDE, ALTUS, OK 73521
(580) 482-0441
(580) 482-0443
Mailing address
112 VAL VERDE, ALTUS, OK 73521
(580) 482-0441
(580) 482-0443
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
4246
OK
122300000X
Dentist
Primary
4975
OK
122300000X
Dentist
6043
OK
302R00000X
Health Maintenance Organization
4975
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1225377925
NPI 1 JON G. HOLMAN
OK
01
—
1487681011
NPI 1 RICHARD HENRY
OK
Enumeration date
04/23/2008
Last updated
08/25/2008
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