Provider Demographics
NPI:1205309648
Name:HENDERSON, LAUREL KELSEY ALYSSA (DDS)
Entity type:Individual
Prefix:DR
First Name:LAUREL
Middle Name:KELSEY ALYSSA
Last Name:HENDERSON
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Gender:F
Credentials:DDS
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Mailing Address - Street 1:725 ALBANY STREET, 6TH FLOOR
Mailing Address - Street 2:SUITE 6A
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118
Mailing Address - Country:US
Mailing Address - Phone:617-358-6775
Mailing Address - Fax:617-358-6781
Practice Address - Street 1:725 ALBANY STREET, 6TH FLOOR
Practice Address - Street 2:SUITE 6A
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118
Practice Address - Country:US
Practice Address - Phone:617-358-6775
Practice Address - Fax:617-358-6781
Is Sole Proprietor?:No
Enumeration Date:2019-01-08
Last Update Date:2025-07-07
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Provider Licenses
StateLicense IDTaxonomies
CA1044771223X2210X, 125Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes125Q00000XDental ProvidersDentistOral Medicine
No1223X2210XDental ProvidersDentistOrofacial Pain