Provider Demographics
NPI:1407900939
Name:HERRIN, LEWIS LARY (DDS)
Entity Type:Individual
Prefix:DR
First Name:LEWIS
Middle Name:LARY
Last Name:HERRIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2410 W UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-2810
Mailing Address - Country:US
Mailing Address - Phone:972-542-2501
Mailing Address - Fax:972-542-1155
Practice Address - Street 1:2410 W UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-2810
Practice Address - Country:US
Practice Address - Phone:972-542-2501
Practice Address - Fax:972-542-1155
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice