Stephen Henneka, L.C.S.W

NPI 1104916428 · on the registry since 2006 · sole proprietor

Practice

Address: 1100 S Ponce De Leon Blvd Ste 1
Saint Augustine, FL 32084
Phone: (904) 824-7733
Fax: (904) 829-9768
Organisation at this address: Smiling Kidds Dentistry, P.A.
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 6

Registry record

Primary taxonomy: 1041C0700X
1041C0700X
Also registered as: 101YM0800X
Licence states on file: FL
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2015-01-14

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Florida