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Individual

PHILIP E HENDERLIGHT JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
1507 S MAIN ST, CORBIN, KY 40701-1932
(606) 523-1110
Mailing address
1507 S MAIN ST, CORBIN, KY 40701-1932
(606) 523-1110

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
KY5414
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
60054145
KY
Enumeration date
03/06/2007
Last updated
07/08/2007
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