Provider Demographics
NPI:1306949961
Name:HENNESSY, RHONDA MCCARTY (DDS DOCTOR OF DENTAL)
Entity type:Individual
Prefix:DR
First Name:RHONDA
Middle Name:MCCARTY
Last Name:HENNESSY
Suffix:
Gender:F
Credentials:DDS DOCTOR OF DENTAL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37235 GODDARD RD
Mailing Address - Street 2:
Mailing Address - City:ROMULUS
Mailing Address - State:MI
Mailing Address - Zip Code:48174
Mailing Address - Country:US
Mailing Address - Phone:734-941-0343
Mailing Address - Fax:734-941-7694
Practice Address - Street 1:37235 GODDARD RD
Practice Address - Street 2:
Practice Address - City:ROMULUS
Practice Address - State:MI
Practice Address - Zip Code:48174
Practice Address - Country:US
Practice Address - Phone:734-941-0343
Practice Address - Fax:734-941-7694
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI0144211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice