Provider Demographics
NPI:1154499739
Name:HIRSCHFELD, ERIC O (DDS)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:O
Last Name:HIRSCHFELD
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 1:51A WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:NH
Mailing Address - Zip Code:03818
Mailing Address - Country:US
Mailing Address - Phone:603-447-1999
Mailing Address - Fax:603-447-5194
Practice Address - Street 1:51A WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:NH
Practice Address - Zip Code:03818
Practice Address - Country:US
Practice Address - Phone:603-447-1999
Practice Address - Fax:603-447-5194
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY22461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30305145Medicaid