Provider Demographics
NPI:1477800795
Name:HERMES, MARC-PHILIPPE HANI (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARC-PHILIPPE
Middle Name:HANI
Last Name:HERMES
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 1:1530 JAMACHA RD STE L
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92019-3757
Mailing Address - Country:US
Mailing Address - Phone:619-447-6464
Mailing Address - Fax:
Practice Address - Street 1:1530 JAMACHA RD STE L
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92019-3757
Practice Address - Country:US
Practice Address - Phone:619-447-6464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-06
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA616671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice