Provider Demographics
NPI:1508876152
Name:HERRMANN, RONALD J (DDS)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:J
Last Name:HERRMANN
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 1:12A N AIRMONT RD
Mailing Address - Street 2:
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-5105
Mailing Address - Country:US
Mailing Address - Phone:845-357-0970
Mailing Address - Fax:845-369-1578
Practice Address - Street 1:12A N AIRMONT RD
Practice Address - Street 2:
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-5105
Practice Address - Country:US
Practice Address - Phone:845-357-0970
Practice Address - Fax:845-369-1578
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY02999511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice