| Amanda Henry DDS PC | |
|
260 E Congress Pkwy Ste C Crystal Lake IL 60014-6235 | |
| (815) 459-4847 | |
| Not Available |
| Full Name | Amanda Henry DDS PC |
|---|---|
| Speciality | Dentist |
| Location | 260 E Congress Pkwy Ste C, Crystal Lake, Illinois |
| Authorized Official Name and Position | Amanda Henry (OWNER) |
| Authorized Official Contact | 8478095312 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Amanda Henry DDS PC 260 E Congress Pkwy Ste C Crystal Lake IL 60014-6235 | Amanda Henry DDS PC 260 E Congress Pkwy Ste C Crystal Lake IL 60014-6235 Ph: (815) 459-4847 |
| NPI Number | 1952197030 |
|---|---|
| Provider Enumeration Date | 04/16/2025 |
| Last Update Date | 04/16/2025 |
| Certification Date | 04/16/2025 |
| Medicare PECOS PAC ID | 2163914482 |
|---|---|
| Medicare Enrollment ID | O20251125000133 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952197030 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (NU) | Primary |
| 332BC3200X | Durable Medical Equipment & Medical Supplies - Customized Equipment | (NU) | Secondary |
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