Provider Demographics
NPI:1316151434
Name:CONAWAY, HENRY LEE JR (DDS)
Entity type:Individual
Prefix:MR
First Name:HENRY
Middle Name:LEE
Last Name:CONAWAY
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:901 NORMAL PARK
Mailing Address - Street 2:SUITE 202
Mailing Address - City:HUNTSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77320-3770
Mailing Address - Country:US
Mailing Address - Phone:936-295-0932
Mailing Address - Fax:936-295-4876
Practice Address - Street 1:901 NORMAL PARK
Practice Address - Street 2:SUITE 202
Practice Address - City:HUNTSVILLE
Practice Address - State:TX
Practice Address - Zip Code:77320-3770
Practice Address - Country:US
Practice Address - Phone:936-295-0932
Practice Address - Fax:936-295-4876
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9044122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist