Healthcare Provider Details

I. General information

NPI: 1962250373
Provider Name (Legal Business Name): HENRY & TRIPP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2024
Last Update Date: 01/28/2025
Certification Date: 01/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 W MAIN ST
HAMLET NC
28345-3321
US

IV. Provider business mailing address

PO BOX 667
HAMLET NC
28345-0667
US

V. Phone/Fax

Practice location:
  • Phone: 910-582-5707
  • Fax: 910-582-5737
Mailing address:
  • Phone: 910-582-5707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. KENNEDI STEWART HENRY
Title or Position: GENERAL DENTIST
Credential: DMD
Phone: 910-995-3510