Provider Demographics
NPI:1306931035
Name:ESPINOSA, HENRY D (DDS)
Entity type:Individual
Prefix:
First Name:HENRY
Middle Name:D
Last Name:ESPINOSA
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 1:10409 MONTGOMERY PKW NE #203
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111
Mailing Address - Country:US
Mailing Address - Phone:505-888-1116
Mailing Address - Fax:505-888-1119
Practice Address - Street 1:10409 MONTGOMERY PKWY NE #203
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111
Practice Address - Country:US
Practice Address - Phone:505-888-1116
Practice Address - Fax:505-888-1119
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2015-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD12351223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics