Individual
JORGE ANDRES HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1 NORTH ST, MARKESAN, WI 53946-8522
(920) 398-2662
Mailing address
455 AQUA CIR, LINO LAKES, MN 55014-2716
(920) 243-3600
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1002061
WI
Other
Enumeration date
06/07/2019
Last updated
06/07/2019
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