Organization
AMANDA HENRY DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA HENRY (OWNER)
(847) 809-5312
Entity
Organization
Contact information
Practice address
260 E CONGRESS PKWY STE C, CRYSTAL LAKE, IL 60014-6235
(815) 459-4847
Mailing address
260 E CONGRESS PKWY STE C, CRYSTAL LAKE, IL 60014-6235
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
332BC3200X
Customized Equipment (DME)
—
—
Other
Enumeration date
04/16/2025
Last updated
04/16/2025
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