Healthcare Provider Details

I. General information

NPI: 1720176266
Provider Name (Legal Business Name): SHIRLIE ANTOINETTE DOWD HERBST OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 NORTH RD
DEERFIELD NH
03037-1400
US

IV. Provider business mailing address

45 NORTH RD
DEERFIELD NH
03037-1400
US

V. Phone/Fax

Practice location:
  • Phone: 603-463-7373
  • Fax: 603-463-7390
Mailing address:
  • Phone: 603-463-7373
  • Fax: 603-463-7390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number829
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: