Mr. Eugenio G Herbosa
Oral & Maxillofacial Surgeon
12818 Tesson Ferry Road Suite 204
St Louis
, Missouri 63128
Mr. Eugenio G Herbosa
Oral & Maxillofacial Surgeon
12818 Tesson Ferry Road Suite 204
St Louis
, Missouri 63128
(314) 721-5276
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About
Features
Specialties
- Oral & Maxillofacial Surgeon
Languages spoken
- English
Location
First Address
- Mr. Eugenio G Herbosa
- 1034 S Brentwood Suite 1010
- St Louis, MO
- Zip : 63128
- Fax : (314) 721-5276
- Phone : (314) 721-1010
Second Address
- Mr. Eugenio G Herbosa
- 12818 Tesson Ferry Road Suite 204
- St Louis, MO
- Zip : 63128
- Fax : (314) 842-1590
- Phone : (314) 842-0020
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 204E00000X | Oral & Maxillofacial Surgeon | 15229 | MO |
National Provider Identifier
| NPI | 1063593838 |
|---|---|
| Provider Name | Mr. Eugenio G Herbosa |
| First Address | St Louis, MO 63128 |
| Second Address | St Louis, MO 63128 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 18/10/2006 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 23435 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.