Provider Demographics
NPI:1811075518
Name:RICHARD P HERMAN DDS PC
Entity type:Organization
Organization Name:RICHARD P HERMAN DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:HERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:845-634-6767
Mailing Address - Street 1:20 SQUADRON BLVD
Mailing Address - Street 2:260
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-5200
Mailing Address - Country:US
Mailing Address - Phone:845-634-6767
Mailing Address - Fax:845-634-6788
Practice Address - Street 1:20 SQUADRON BLVD
Practice Address - Street 2:260
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-5200
Practice Address - Country:US
Practice Address - Phone:845-634-6767
Practice Address - Fax:845-634-6788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY311231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty