Individual
JOHN HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
6532 REISTERSTOWN RD, BALTIMORE, MD 21215-2304
(410) 585-0010
Mailing address
809 S ROSE ST, BALTIMORE, MD 21224-3740
(443) 523-5076
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
17340
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/04/2021
Last updated
07/12/2022
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