Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 1425 | PR |
NPI | 1144356544 |
---|---|
Provider Name | Mr. Francisco Herrero SR. |
First Address | Bayamon, PR 00961-6902 |
Second Address | Bayamon, PR 00961 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2007 |
Last Update Date | 08/07/2007 |