=====================================================
General NPI Number Information
=====================================================
NPI Number | 1144356544
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | FRANCISCO HERRERO SR. DMD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/27/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | B8 SANTA CRUZ
-----------------------------------------------------
City | BAYAMON
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00961
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-269-8687
-----------------------------------------------------
Fax | 787-786-4891
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | B8 SANTA CRUZ
-----------------------------------------------------
City | BAYAMON
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00961-6902
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-269-8687
-----------------------------------------------------
Fax | 787-786-4891
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223P0300X
-----------------------------------------------------
Taxonomy Name | Periodontics
-----------------------------------------------------
License Number | 1425
-----------------------------------------------------
License Number State | PR
-----------------------------------------------------