Provider Demographics
NPI:1932195237
Name:HERRON, ALLEN JOEL (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:JOEL
Last Name:HERRON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 SOCIETY HILL BLVD
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-2405
Mailing Address - Country:US
Mailing Address - Phone:609-636-7060
Mailing Address - Fax:
Practice Address - Street 1:235 SOCIETY HILL BLVD
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-2405
Practice Address - Country:US
Practice Address - Phone:609-636-7060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-22
Last Update Date:2019-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS023761L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist