Healthcare Provider Details

I. General information

NPI: 1124239488
Provider Name (Legal Business Name): ANDRES F HERRERA DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/25/2007
Last Update Date: 12/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

546 ABBOTT ST
SALINAS CA
93901-4000
US

IV. Provider business mailing address

546 ABBOTT ST
SALINAS CA
93901-4357
US

V. Phone/Fax

Practice location:
  • Phone: 831-424-7393
  • Fax: 831-424-7953
Mailing address:
  • Phone: 831-424-7393
  • Fax: 831-424-7953

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0106X
TaxonomyOral and Maxillofacial Pathology Dentistry
License Number53705
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: