Walter E Henderson D.D.S.

NPI 1013079656 - Dentist - 1223G0001X

NPI Details
NPI 1013079656
Gender Male
Enumeration Date 12/13/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
179 N CHURCH AVE
SUITE 102
FAYETTEVILLE AR, 72701, US
Phone (479) 442-6512
Fax (479) 442-7817
Business Location
179 N CHURCH AVE
SUITE 102
FAYETTEVILLE AR, 72701-5265, US
Phone (479) 442-6512
Fax (479) 442-7817
Toxanomy
Taxonomy Code 1223G0001X
License State Tennessee
License Number 2240
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According to our database, Dr. Walter E Henderson D.D.S. NPI is 1013079656, taxonomy code is 1223G0001X and license number is 2240, license state is located at Tennessee. Walter E Henderson D.D.S. physically located at 179 N Church Ave, Fayetteville AR, 72701. NPI Number Walter E Henderson D.D.S. has the Individual type.

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1013079656 NPI number is provided on an as is basis without warranty of any kind. 1013079656 is maintained by the National Plan & Provider Enumeration System. The contents of Walter E Henderson D.D.S. are for informational purposes only.