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Individual
DR. JERRY HERNANDEZ
Active
Individual
DR. JERRY HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
0401413249
VA
1223G0001X
General Practice Dentistry
Primary
60539
CA
Other
Enumeration date
06/20/2011
Last updated
04/04/2012
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