Individual
JASON HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
40 MANSFIELD AVE, WILLIMANTIC, CT 06226-2018
(860) 450-7471
(860) 450-9808
Mailing address
40 MANSFIELD AVE, WILLIMANTIC, CT 06226-2018
(860) 450-7471
(860) 450-9808
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
010829
CT
Other
Enumeration date
07/01/2011
Last updated
06/13/2014
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