Provider Demographics
NPI:1679684070
Name:HENRY, CHRISTOPHER HANS (DMD MS PC)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:HANS
Last Name:HENRY
Suffix:
Gender:
Credentials:DMD MS PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:491 PROSPERITY LAKE DR STE 301
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32092-5045
Mailing Address - Country:US
Mailing Address - Phone:904-429-0095
Mailing Address - Fax:904-429-0238
Practice Address - Street 1:491 PROSPERITY LAKE DR STE 301
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32092-5045
Practice Address - Country:US
Practice Address - Phone:904-429-0095
Practice Address - Fax:904-429-0238
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK10991223P0221X
AKAA10991223X0400X
FLDN223751223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No1223P0221XDental ProvidersDentistPediatric Dentistry