Individual
JONATHAN SHANE HENSLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
126 TRIVETTE DR STE 103, PIKEVILLE, KY 41501-1275
(606) 433-1488
(606) 433-1487
Mailing address
126 TRIVETTE DR STE 103, PIKEVILLE, KY 41501-1275
(606) 433-1488
(606) 433-1487
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7602
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60000353
—
KY
Enumeration date
10/13/2006
Last updated
04/04/2012
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