Provider Demographics
NPI:1831348705
Name:HERRERA, MERCEDES JOSEFINA (DDS)
Entity type:Individual
Prefix:DR
First Name:MERCEDES
Middle Name:JOSEFINA
Last Name:HERRERA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80545 US HIGHWAY 111 # 3
Mailing Address - Street 2:
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92201-6532
Mailing Address - Country:US
Mailing Address - Phone:760-342-9938
Mailing Address - Fax:760-342-9967
Practice Address - Street 1:80545 US HIGHWAY 111 # 3
Practice Address - Street 2:
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92201-6532
Practice Address - Country:US
Practice Address - Phone:760-342-9938
Practice Address - Fax:760-342-9967
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-15
Last Update Date:2013-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45267122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist