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General NPI Number Information
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NPI Number | 1750773776
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Entity Type | Organization
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Legal Business Name | HENRIOD AND PAPWORTH DENTAL CORPORATION
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Dates
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Enumeration Date | 02/27/2015
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Last Update Date | 01/09/2023
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Provider Practice Location Address
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Address Line | 40250 MURRIETA HOT SPRINGS RD SUITE 119
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City | MURRIETA
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State | CA
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Zip | 92563-4961
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Country | US
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Telephone | 951-698-4426
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Fax | 951-698-7570
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Provider Business Mailing Address
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Address Line | 40250 MURRIETA HOT SPRINGS RD SUITE 119
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City | MURRIETA
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State | CA
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Zip | 92563-4961
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Country | US
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Telephone | 951-698-4426
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Fax | 951-698-7570
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | MR. MICHAEL HENRIOD
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Credential |
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Telephone | 951-698-4426
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 55124
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 39843
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 39843
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License Number State | CA
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