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General NPI Number Information
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NPI Number | 1619164241
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Entity Type | Organization
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Legal Business Name | RENE HERRERA D.D.S INC.
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Dates
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Enumeration Date | 09/27/2007
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Last Update Date | 09/27/2007
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Provider Practice Location Address
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Address Line | 141 E PUTNAM AVE
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City | PORTERVILLE
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State | CA
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Zip | 93257-3832
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Country | US
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Telephone | 559-781-2729
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Fax | 559-781-2734
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Provider Business Mailing Address
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Address Line | 141 E PUTNAM AVE
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City | PORTERVILLE
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State | CA
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Zip | 93257-3832
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Country | US
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Telephone | 559-781-2729
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Fax | 559-781-2734
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RENE HERRERA
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Credential |
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Telephone | 559-781-2729
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 51773
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License Number State | CA
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