Provider Demographics
NPI:1124038427
Name:HIRSCH, DAVID L (DDS, MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:L
Last Name:HIRSCH
Suffix:
Gender:M
Credentials:DDS, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:366 5TH AVE
Mailing Address - Street 2:SUITE 709
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-2211
Mailing Address - Country:US
Mailing Address - Phone:212-629-3223
Mailing Address - Fax:212-629-3466
Practice Address - Street 1:366 5TH AVE
Practice Address - Street 2:SUITE 709
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-2211
Practice Address - Country:US
Practice Address - Phone:212-629-3223
Practice Address - Fax:212-629-3466
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY0483461223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery