Provider Demographics
NPI:1033223193
Name:HERRINGTON AND NUNN DENTAL ASSOCIATES
Entity Type:Organization
Organization Name:HERRINGTON AND NUNN DENTAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR.
Authorized Official - Prefix:DR
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:HERRINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:936-756-1444
Mailing Address - Street 1:1005 LONGMIRE RD
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-1826
Mailing Address - Country:US
Mailing Address - Phone:936-756-1444
Mailing Address - Fax:936-756-1499
Practice Address - Street 1:1005 LONGMIRE RD
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-1826
Practice Address - Country:US
Practice Address - Phone:936-756-1444
Practice Address - Fax:936-756-1499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2008-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10411122300000X
TX19109122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty