MEDICARE: DR. ROBERT ERIC HENNER D.D.S., P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	12158	FL

General Provider Information

NPI Number	:	1548279789
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT ERIC HENNER D.D.S., P.A.

Provider Business Mailing Address
First Line	:	840 US HIGHWAY 1
Second Line	:	SUITE 215
City	:	NORTH PALM BEACH
State	:	FL
Zip	:	33408-3830
Country	:	US
Telephone Number	:	561-626-8300
Fax Number	:	561-627-7574

Provider Business Practice Location Address
First Line	:	840 US HIGHWAY 1
Second Line	:	SUITE 215
City	:	NORTH PALM BEACH
State	:	FL
Zip	:	33408-3830
Country	:	US
Telephone Number	:	561-626-8300
Fax Number	:	561-627-7574

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/05/2006
Last Update Date	:	07/08/2007

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