Individual
WILLIAM HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
601 N CAROLINE ST, BALTIMORE, MD 21287-0006
(410) 955-6662
Mailing address
PO BOX 64767, BALTIMORE, MD 21264-4767
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
12085
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
218000600
—
MD
Enumeration date
05/13/2006
Last updated
10/27/2008
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