Provider Demographics
NPI:1881728202
Name:HIRSCHENBERGER, ANTHONY (DDS)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:
Last Name:HIRSCHENBERGER
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 1:9301 CALUMET AVE
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-2809
Mailing Address - Country:US
Mailing Address - Phone:219-836-8316
Mailing Address - Fax:219-836-8431
Practice Address - Street 1:9301 CALUMET AVE
Practice Address - Street 2:SUITE 2A
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-2809
Practice Address - Country:US
Practice Address - Phone:219-836-8316
Practice Address - Fax:219-836-8431
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN120085811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice