Basic Information
| Provider Information | |||||||||
| NPI: | 1003150673 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FOERSTER | ||||||||
| FirstName: | HENRY | ||||||||
| MiddleName: | ANDREW | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5620 NW 43RD RD | ||||||||
| Address2: | |||||||||
| City: | GAINESVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 326064378 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3525145588 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2133 PEPPERRELL ST | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782365313 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2102923894 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/20/2012 | ||||||||
| LastUpdateDate: | 11/20/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223P0300X | DN18981 | FL | Y | Dental Providers | Dentist | Periodontics |
No ID Information.