Provider Demographics
NPI:1366459083
Name:E J HERTZFELD DDS PA
Entity Type:Organization
Organization Name:E J HERTZFELD DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:HERTZFELD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:302-654-4484
Mailing Address - Street 1:1900 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19802
Mailing Address - Country:US
Mailing Address - Phone:302-654-4484
Mailing Address - Fax:302-654-2505
Practice Address - Street 1:1900 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19802
Practice Address - Country:US
Practice Address - Phone:302-654-4484
Practice Address - Fax:302-654-2505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEDE7881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty