Individual
DR. BONIFACIO HERNANDEZ LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2203 N RAUL LONGORIA RD STE B2, SAN JUAN, TX 78589-5118
(956) 314-1684
Mailing address
2203 N RAUL LONGORIA RD STE B2, SAN JUAN, TX 78589-5118
(956) 314-1684
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1180600
ZZ
Other
Enumeration date
07/19/2013
Last updated
07/19/2013
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