Individual
HENLEY EDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2648 APD 40, CLEVELAND, TN 37323-0695
(423) 472-0709
Mailing address
2648 APD 40, CLEVELAND, TN 37323-0695
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
13193
TN
Other
Enumeration date
06/25/2026
Last updated
06/25/2026
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