Individual
AUBREY J HENSHAW III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
611 W RUTH AVE, SALLISAW, OK 74955-6866
(918) 775-4431
(918) 775-4432
Mailing address
PO BOX 708, SALLISAW, OK 74955-0708
(918) 775-4431
(918) 775-4432
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
75227
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100132280B
—
OK
Enumeration date
07/18/2006
Last updated
04/04/2017
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