Individual
DR. BRIAN T HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1419 SUPERIOR AVE, SUITE #6, NEWPORT BEACH, CA 92663-2723
(949) 646-4801
Mailing address
1419 SUPERIOR AVE, SUITE #6, NEWPORT BEACH, CA 92663-2723
(949) 646-4801
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
33776
CA
Other
Enumeration date
08/06/2009
Last updated
08/06/2009
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