Provider Demographics
NPI:1043669310
Name:HERMAN, ERIC J (DDS)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:J
Last Name:HERMAN
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 1:206 5TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:DEVILS LAKE
Mailing Address - State:ND
Mailing Address - Zip Code:58301-3602
Mailing Address - Country:US
Mailing Address - Phone:701-662-8191
Mailing Address - Fax:701-662-5757
Practice Address - Street 1:206 5TH AVE SE
Practice Address - Street 2:
Practice Address - City:DEVILS LAKE
Practice Address - State:ND
Practice Address - Zip Code:58301-3602
Practice Address - Country:US
Practice Address - Phone:701-662-8191
Practice Address - Fax:701-662-5757
Is Sole Proprietor?:No
Enumeration Date:2016-06-08
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND2283122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist