Provider Demographics
NPI:1154487551
Name:HERRSCHER, KATHLEEN
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:
Last Name:HERRSCHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N80W17707 CUSTER LN
Mailing Address - Street 2:
Mailing Address - City:MENOMONEE FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:53051-3630
Mailing Address - Country:US
Mailing Address - Phone:262-255-2727
Mailing Address - Fax:262-255-3903
Practice Address - Street 1:N80W17707 CUSTER LN
Practice Address - Street 2:
Practice Address - City:MENOMONEE FALLS
Practice Address - State:WI
Practice Address - Zip Code:53051-3630
Practice Address - Country:US
Practice Address - Phone:262-255-2727
Practice Address - Fax:262-255-3903
Is Sole Proprietor?:No
Enumeration Date:2006-12-29
Last Update Date:2016-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI47501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice