Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | DN18981 | FL |
NPI | 1003150673 |
---|---|
Provider Name | Dr. Henry Andrew Foerster |
First Address | Gainesville, FL 32606-4378 |
Second Address | San Antonio, TX 78236-5313 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2012 |
Last Update Date | 20/11/2012 |