Provider Demographics
NPI:1578090452
Name:HERSEY, ERIN (DMD)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:
Last Name:HERSEY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 ISABELLA DR
Mailing Address - Street 2:
Mailing Address - City:LONDONDERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03053-3051
Mailing Address - Country:US
Mailing Address - Phone:603-845-8247
Mailing Address - Fax:603-845-8247
Practice Address - Street 1:292 CHAUNCY ST # 150
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:MA
Practice Address - Zip Code:02048-1203
Practice Address - Country:US
Practice Address - Phone:508-261-9261
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-22
Last Update Date:2017-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18575651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice