Provider Demographics
NPI:1104796168
Name:HERTZEL DENTISTRY LLC
Entity type:Organization
Organization Name:HERTZEL DENTISTRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HERTZEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:614-204-3108
Mailing Address - Street 1:114 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEW CONCORD
Mailing Address - State:OH
Mailing Address - Zip Code:43762-1143
Mailing Address - Country:US
Mailing Address - Phone:740-826-4748
Mailing Address - Fax:740-826-7377
Practice Address - Street 1:114 W MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW CONCORD
Practice Address - State:OH
Practice Address - Zip Code:43762-1143
Practice Address - Country:US
Practice Address - Phone:740-826-4748
Practice Address - Fax:740-826-7377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-06
Last Update Date:2025-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental