Healthcare Provider Details

I. General information

NPI: 1154688539
Provider Name (Legal Business Name): EUGENE G. HERMAN, DMD, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2012
Last Update Date: 04/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 N CENTRE AVE SUITE 303
ROCKVILLE CENTRE NY
11570-3923
US

IV. Provider business mailing address

77 N CENTRE AVE SUITE 303
ROCKVILLE CENTRE NY
11570-3923
US

V. Phone/Fax

Practice location:
  • Phone: 516-766-3330
  • Fax: 516-766-3563
Mailing address:
  • Phone: 516-766-3330
  • Fax: 516-766-3563

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License Number
License Number State

VIII. Authorized Official

Name: DR. EUGENE GEORGE HERMAN
Title or Position: PRESIDENT
Credential: DMD
Phone: 516-766-3330