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Individual

DR. KYLE LEA HENRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
1109 CARDENAS DR NE, ALBUQUERQUE, NM 87110-6617
(505) 836-0322
Mailing address
MSC 06 3500 1 UNIVERSITY OF NEW MEXICO, ALBUQUERQUE, NM 87131-0001

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DD4640
NM
390200000X
Student in an Organized Health Care Education/Training Program
NM

Other

Enumeration date
02/14/2016
Last updated
09/24/2024
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