Individual
DR. THERESA DEOGRACIS HERINGHAUS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
480 GLESSNER AVE, MANSFIELD, OH 44903-2056
(419) 524-7409
(419) 526-3870
Mailing address
2401 VALLEY RD, MANSFIELD, OH 44903-8517
(419) 529-0451
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
18764
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2368736
—
OH
Enumeration date
01/05/2006
Last updated
07/08/2007
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