Provider Demographics
NPI:1164941795
Name:ANDREW V HERWIG DDS PA
Entity Type:Organization
Organization Name:ANDREW V HERWIG DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:GALYARDT
Authorized Official - Last Name:HERWIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-492-8884
Mailing Address - Street 1:11900 W 87TH STREET PKWY STE 260
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66215-4517
Mailing Address - Country:US
Mailing Address - Phone:913-492-8884
Mailing Address - Fax:913-492-4582
Practice Address - Street 1:11900 W 87TH STREET PKWY STE 260
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66215-4517
Practice Address - Country:US
Practice Address - Phone:913-492-8884
Practice Address - Fax:913-492-4582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty