| Jason D. Henderson, Dds Pc | |
|
8179 Cazenovia Rd Manlius NY 13104-9778 | |
| (315) 685-2246 | |
| (315) 682-3914 |
| Full Name | Jason D. Henderson, Dds Pc |
|---|---|
| Speciality | Dentist |
| Location | 8179 Cazenovia Rd, Manlius, New York |
| Authorized Official Name and Position | Jason D. Henderson (OWNER/ DENTIST) |
| Authorized Official Contact | 3156822466 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jason D. Henderson, Dds Pc 8179 Cazenovia Rd Manlius NY 13104-9778 Ph: (315) 685-2246 | Jason D. Henderson, Dds Pc 8179 Cazenovia Rd Manlius NY 13104-9778 Ph: (315) 685-2246 |
| NPI Number | 1316096340 |
|---|---|
| Provider Enumeration Date | 01/09/2007 |
| Last Update Date | 09/10/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316096340 | NPI | - | NPPES |
| 03224320 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 054488 (New York) | Primary |
Gary L. Revercomb, Dmd Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 8076 Cazenovia Rd, Manlius, NY 13104 Phone: 315-682-8400 Fax: 315-682-2602 | |
William H. Karp, D.d.s., Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 8179 Cazenovia Rd, Manlius, NY 13104 Phone: 315-682-2386 Fax: 315-682-3914 | |
Fayetteville-manlius Oral Surgery, P.c Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 8240 Cazenovia Rd Ste 60, Manlius, NY 13104 Phone: 315-692-0449 Fax: 315-692-6546 |