Organization
L. M. HENDERSON D.M.D.,P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY M HENDERSON D.M.D.,P.A. (DENTIST)
(501) 835-0444
Entity
Organization
Contact information
Practice address
3006 E KIEHL AVE, SHERWOOD, AR 72120-3228
(501) 835-0444
(501) 835-8730
Mailing address
3006 E KIEHL AVE, SHERWOOD, AR 72120-3228
(501) 835-0444
(501) 835-8730
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2209
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5C125
BCBS
AR
Enumeration date
01/28/2008
Last updated
01/28/2008
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