Individual
DR. ENRIQUE HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ENRIQUE HERNANDEZ
Contact information
Practice address
2539 N KEDZIE BLVD, 2, CHICAGO, IL 60647-1670
(773) 235-3292
Mailing address
2539 N KEDZIE BLVD, 2, CHICAGO, IL 60647-1670
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019018385
IL
Other
Enumeration date
10/03/2012
Last updated
10/03/2012
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