Individual
DR. MAURICIO JOSE HERRERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
10601 GREENYARD WAY STE B, CHESTER, VA 23831-1485
(804) 472-8099
(804) 270-4873
Mailing address
11545 A NUCKOIS ROAD, GLEN ALLEN, VA 23059-5666
(804) 673-8061
(804) 673-5644
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
0401413331
VA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
0401413331
VA
Other
Enumeration date
07/11/2008
Last updated
01/29/2024
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