Individual
AVERY HERRERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1478 POST RD, FAIRFIELD, CT 06824-5938
(203) 307-1550
Mailing address
550 1ST AVE, NEW YORK, NY 10016-6402
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
13703
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
106638
DENTAL BOARD OF CALIFORNIA
CA
Enumeration date
06/02/2021
Last updated
07/17/2023
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