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General NPI Number Information
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NPI Number | 1104533660
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Entity Type | Organization
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Legal Business Name | ANDREW W HENRITZE DDS PLLC
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Dates
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Enumeration Date | 11/03/2022
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Last Update Date | 06/18/2025
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Provider Practice Location Address
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Address Line | 3611 BRAMBLETON AVE
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City | ROANOKE
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State | VA
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Zip | 24018-3611
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Country | US
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Telephone | 540-991-5151
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Fax | 540-202-9339
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Provider Business Mailing Address
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Address Line | PO BOX 52492
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City | PHOENIX
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State | AZ
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Zip | 85072-2492
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ACCOUNTS RECEIVEABLE ANALYST
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Name | REBECCA HAWKINS HARRIS
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Credential |
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Telephone | 544-077-6655
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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