Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223P0221X | Pediatric Dentist | DEN03114 | RI |
Y | 1223P0221X | Pediatric Dentist | DN1855848 | MA |
NPI | 1083906341 |
---|---|
Provider Name | Dr. Jason Hencler |
First Address | Taunton, MA 02780-5403 |
Second Address | Taunton, MA 02780-5403 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2011 |
Last Update Date | 20/10/2016 |