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1073636130
JOHNNY J HERNANDEZ
BLOOMINGTON, IL
NPI
1073636130
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: IL 019025505)
Enumeration Date
2007-04-06
Last Update Date
2007-07-08
Business Address
-- JOHNNY J HERNANDEZ DDS
10 HEARTLAND DR SUITE A
BLOOMINGTON, IL 61704-7741
Phone number: 309-662-0523
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Mailing Address
-- JOHNNY J HERNANDEZ DDS
13715 FAWN DR
BLOOMINGTON, IL 61704-7834
Phone number: 309-828-1110
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