Provider Demographics
NPI:1548438898
Name:HENDERSON, CLAUDE DUDLEY (DDS)
Entity type:Individual
Prefix:DR
First Name:CLAUDE
Middle Name:DUDLEY
Last Name:HENDERSON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 547
Mailing Address - Street 2:
Mailing Address - City:LEAKEY
Mailing Address - State:TX
Mailing Address - Zip Code:78873-0547
Mailing Address - Country:US
Mailing Address - Phone:830-232-5273
Mailing Address - Fax:
Practice Address - Street 1:HWY 83 & OAK HILL
Practice Address - Street 2:
Practice Address - City:LEAKEY
Practice Address - State:TX
Practice Address - Zip Code:78873
Practice Address - Country:US
Practice Address - Phone:830-232-5273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-20
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8784122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist