Provider Demographics
NPI:1407996242
Name:HERBRANSON, ERIC JAMES (DDS)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:JAMES
Last Name:HERBRANSON
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 1:299 JUANA AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577-4838
Mailing Address - Country:US
Mailing Address - Phone:510-895-1470
Mailing Address - Fax:510-895-1473
Practice Address - Street 1:299 JUANA AVE
Practice Address - Street 2:SUITE A
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-4838
Practice Address - Country:US
Practice Address - Phone:510-895-1470
Practice Address - Fax:510-895-1473
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA212581223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics