Provider Demographics
NPI:1487666418
Name:HERSCHER, CARL DAVID (DDS)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:DAVID
Last Name:HERSCHER
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 1:712 BLUE JACK PT
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-5113
Mailing Address - Country:US
Mailing Address - Phone:843-849-6585
Mailing Address - Fax:
Practice Address - Street 1:712 BLUE JACK POINT
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-5113
Practice Address - Country:US
Practice Address - Phone:843-849-6585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC23311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice