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Individual

RICK HERRMANN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS MS

Contact information

Practice address
2300 MATLOCK RD, SUITE 28, MANSFIELD, TX 76063
(817) 473-9880
(817) 473-3818
Mailing address
2300 MATLOCK RD, SUITE 28, MANSFIELD, TX 76063
(817) 473-9880
(817) 473-3818

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
016967
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
86D839
BCBS
TX
Enumeration date
12/19/2006
Last updated
07/08/2007
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