Individual
GLORIA BLAKE HENSLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1902 48TH ST, VALLEY, AL 36854-3634
(334) 756-4000
Mailing address
1013 STONEGATE DR APT C, AUBURN, AL 36832-1628
(606) 309-6586
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D-0006829-C1
AL
Other
Enumeration date
11/09/2020
Last updated
11/09/2020
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