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Contact Information

WALTER E HENDERSON, DDS
179 N CHURCH AVE
SUITE 102
FAYETTEVILLE, AR72701
 Phone: 479-442-6512
 Fax: 479-442-7817
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for WALTER E HENDERSON · (Male)

NPI Number 1013079656
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 12/13/2006
Last updated 07/08/2007 - About 12 years ago
Sole proprietor 1 Yes
Identifiers
  • TN License # 2240
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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