Individual
DR. WALTER E HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
179 N CHURCH AVE, SUITE 102, FAYETTEVILLE, AR 72701
(479) 442-6512
(479) 442-7817
Mailing address
179 N CHURCH AVE, SUITE 102, FAYETTEVILLE, AR 72701-5265
(479) 442-6512
(479) 442-7817
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2240
TN
Other
Enumeration date
12/13/2006
Last updated
07/08/2007
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