Provider Demographics
NPI:1063622389
Name:HENSLEY, DAVID (DDS)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:HENSLEY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 MERIDIAN E
Mailing Address - Street 2:STE 27
Mailing Address - City:MILTON
Mailing Address - State:WA
Mailing Address - Zip Code:98354-7001
Mailing Address - Country:US
Mailing Address - Phone:253-922-5401
Mailing Address - Fax:
Practice Address - Street 1:900 MERIDIAN E
Practice Address - Street 2:STE 27
Practice Address - City:MILTON
Practice Address - State:WA
Practice Address - Zip Code:98354-7001
Practice Address - Country:US
Practice Address - Phone:253-922-5401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA7428122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist