Provider Demographics
NPI:1437483732
Name:HIRSCHORN, MARC DREW (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:DREW
Last Name:HIRSCHORN
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 1:10 OLD MAMARONECK RD
Mailing Address - Street 2:SUITE # 1C
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605-1747
Mailing Address - Country:US
Mailing Address - Phone:914-761-5505
Mailing Address - Fax:
Practice Address - Street 1:10 OLD MAMARONECK RD
Practice Address - Street 2:SUITE # 1C
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-1747
Practice Address - Country:US
Practice Address - Phone:914-761-5505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-21
Last Update Date:2009-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0354381223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics