Provider Demographics
NPI:1073853362
Name:EGERT, HERBERT (DDS)
Entity Type:Individual
Prefix:
First Name:HERBERT
Middle Name:
Last Name:EGERT
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 1:4 E ROLLING CROSSROADS
Mailing Address - Street 2:SUITE 205
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-6210
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4 E ROLLING CROSSROADS
Practice Address - Street 2:SUITE 205
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-6210
Practice Address - Country:US
Practice Address - Phone:410-719-7900
Practice Address - Fax:410-719-7816
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-22
Last Update Date:2013-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD88311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice