Individual
HIRVING HENRIQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
53 FAIRVIEW ST, BRATTLEBORO, VT 05301-6630
(802) 490-2923
Mailing address
82 CRYSTAL BROOK DRIVE, SPRINGFIELD, MA 01118-3755
(917) 214-4343
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
016.0134056
VT
1223G0001X
General Practice Dentistry
04950
NH
1223G0001X
General Practice Dentistry
2023016832
MO
390200000X
Student in an Organized Health Care Education/Training Program
13751
CT
Other
Enumeration date
09/21/2021
Last updated
05/23/2024
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