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General NPI Number Information
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NPI Number | 1508206301
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Entity Type | Organization
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Legal Business Name | ROBERT D. HERRON JR. DDS PA
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Dates
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Enumeration Date | 06/26/2013
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Last Update Date | 06/26/2013
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Provider Practice Location Address
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Address Line | 806 E MAPLE ST
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City | COLUMBUS
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State | KS
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Zip | 66725-1924
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Country | US
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Telephone | 620-429-1020
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Fax | 620-429-3267
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Provider Business Mailing Address
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Address Line | 806 E MAPLE ST PO BOX 507
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City | COLUMBUS
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State | KS
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Zip | 66725-1924
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Country | US
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Telephone | 620-429-1020
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Fax | 620-429-3267
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBERT D HERRON
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Credential | DDS
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Telephone | 620-429-1020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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