Provider Demographics
NPI:1447386594
Name:DIETZ, HERBERT MICHAEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:HERBERT
Middle Name:MICHAEL
Last Name:DIETZ
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 1:9 KEATS RD
Mailing Address - Street 2:
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-3219
Mailing Address - Country:US
Mailing Address - Phone:215-295-1907
Mailing Address - Fax:
Practice Address - Street 1:770 RIVER RD
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08628-3347
Practice Address - Country:US
Practice Address - Phone:609-883-3700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-25
Last Update Date:2024-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNJ65421223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics