Herron, Gary Robert

Herron, Gary Robert is an individual health care provider with primary practice located at 171 Inner Loop Road , Fort Irwin CA 92310. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Dental Providers / General Practice. Dental Providers / General Practice is his primary health care specialty. Herron, Gary Robert can be contacted via phone (915) 742-2685.

Contact Information

Primary practice address
171 Inner Loop Road Fort Irwin CA 92310
Phone: (915) 742-2685
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Dental Providers / General Practice 1223G0001X DEN.00205200 Colorado

Profile Details

NPI number 1700506821
LBN Legal business name Herron, Gary Robert
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2022
Last updated Sep 13th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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