Provider Demographics
NPI:1316160716
Name:HONICK III, HENRY (DDS)
Entity type:Individual
Prefix:DR
First Name:HENRY
Middle Name:
Last Name:HONICK III
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 1:4367 HOLLINS FERRY RD
Mailing Address - Street 2:SUITE 4C
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21227-3400
Mailing Address - Country:US
Mailing Address - Phone:410-536-7279
Mailing Address - Fax:410-536-1007
Practice Address - Street 1:4367 HOLLINS FERRY RD
Practice Address - Street 2:SUITE 4C
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21227-3400
Practice Address - Country:US
Practice Address - Phone:410-536-7279
Practice Address - Fax:410-536-1007
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD110631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice