Individual
MR. EUGENIO G HERBOSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD MMSC
Contact information
Practice address
12818 TESSON FERRY ROAD, SUITE 204, ST LOUIS, MO 63128
(314) 842-0020
(314) 842-1590
Mailing address
1034 S BRENTWOOD, SUITE 1010, ST LOUIS, MO 63128
(314) 721-1010
(314) 721-5276
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
15229
MO
Other
Enumeration date
10/18/2006
Last updated
07/08/2007
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