Individual
DR. GARY MARSHALL HENLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
6156 EVERGREEN BLVD, BERKELEY, MO 63134-2108
(314) 522-1032
(314) 524-1292
Mailing address
6156 EVERGREEN BLVD, BERKELEY, MO 63134-2108
(314) 522-1032
(314) 524-1292
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
014443
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
402309207
—
MO
Enumeration date
10/13/2005
Last updated
04/05/2010
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