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Individual

SARITA M HENRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
1217 ROYAL DR, STE 262, CONYERS, GA 30094
(770) 922-6655
(770) 388-0521
Mailing address
1217 ROYAL DR, CONYERS, GA 30094
(770) 922-6655
(770) 388-0521

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DN012241
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000900974A
GA
Enumeration date
05/15/2007
Last updated
01/22/2010
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