Provider Demographics
NPI:1376778456
Name:HERALD FAMILY DENISTRY PLLC
Entity Type:Organization
Organization Name:HERALD FAMILY DENISTRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:D.M.D.
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:HERALD
Authorized Official - Suffix:II
Authorized Official - Credentials:DMD
Authorized Official - Phone:859-781-0221
Mailing Address - Street 1:725 ALEXANDRIA PIKE STE 100
Mailing Address - Street 2:
Mailing Address - City:FORT THOMAS
Mailing Address - State:KY
Mailing Address - Zip Code:41075-2168
Mailing Address - Country:US
Mailing Address - Phone:859-781-0221
Mailing Address - Fax:859-781-0288
Practice Address - Street 1:725 ALEXANDRIA PIKE STE 100
Practice Address - Street 2:
Practice Address - City:FORT THOMAS
Practice Address - State:KY
Practice Address - Zip Code:41075-2168
Practice Address - Country:US
Practice Address - Phone:859-781-0221
Practice Address - Fax:859-781-0288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-19
Last Update Date:2019-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty