Individual
DR. DEVERE J HERRON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
7203 SOUTH WESTERN AVENUE, CHICAGO, IL 60636
(773) 476-5335
(773) 476-4353
Mailing address
7203 SOUTH WESTERN AVENUE, CHICAGO, IL 60636
(773) 476-5335
(773) 476-4353
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019022784
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
019022784
STATE LICENSE
IL
Enumeration date
05/04/2007
Last updated
07/08/2007
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