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General NPI Number Information
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NPI Number | 1528544160
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Entity Type | Individual
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Provider Name | CYRIL HENRY DDS
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Gender | Male
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Dates
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Enumeration Date | 07/17/2018
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Last Update Date | 03/21/2024
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Provider Practice Location Address
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Address Line | 961 SANFORD AVE
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City | IRVINGTON
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State | NJ
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Zip | 07111-1421
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Country | US
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Telephone | 201-364-2564
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Fax |
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Provider Business Mailing Address
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Address Line | 11 MORRISSEE AVE
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City | WALLINGTON
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State | NJ
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Zip | 07057-2211
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Country | US
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Telephone | 201-364-3564
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 22DI02746300
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 34439
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License Number State | TX
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