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General NPI Number Information
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NPI Number | 1134335698
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Entity Type | Organization
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Legal Business Name | MICHAEL E HENDERSON D.M.D. P.A.
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Dates
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Enumeration Date | 05/14/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 128 W CHEROKEE ST
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City | CHESNEE
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State | SC
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Zip | 29323-1226
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Country | US
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Telephone | 864-461-3113
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Fax |
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Provider Business Mailing Address
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Address Line | 128 W CHEROKEE ST
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City | CHESNEE
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State | SC
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Zip | 29323-1226
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Country | US
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Telephone | 864-461-3113
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL E. HENDERSON
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Credential | D.M.D.
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Telephone | 864-461-3113
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2869
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License Number State | SC
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