Provider Demographics
NPI:1497887806
Name:HERSCHFELD, JERRY J (DDS)
Entity Type:Individual
Prefix:
First Name:JERRY
Middle Name:J
Last Name:HERSCHFELD
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 1:3101 BRISTOL RD STE 6
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-2168
Mailing Address - Country:US
Mailing Address - Phone:215-757-7000
Mailing Address - Fax:215-757-3180
Practice Address - Street 1:3101 BRISTOL RD STE 6
Practice Address - Street 2:
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-2168
Practice Address - Country:US
Practice Address - Phone:215-757-7000
Practice Address - Fax:215-757-3180
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS018369L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice