Individual
DR. MARK REAGAN HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
5700 ARNOLD ST, TINKER AFB, OK 73145-8105
(405) 736-2113
Mailing address
5700 ARNOLD ST, TINKER AFB, OK 73145-8105
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
13986
TX
Other
Enumeration date
07/19/2006
Last updated
09/02/2009
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