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General NPI Number Information
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NPI Number | 1003052895
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Entity Type | Individual
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Provider Name | JAMES P. HERMAN D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 12/28/2008
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Last Update Date | 12/28/2008
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Provider Practice Location Address
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Address Line | 5624 S BONNIE LN
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City | HALES CORNERS
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State | WI
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Zip | 53130-1674
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Country | US
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Telephone | 414-425-5841
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Fax |
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Provider Business Mailing Address
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Address Line | 5624 S BONNIE LN
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City | HALES CORNERS
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State | WI
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Zip | 53130-1674
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Country | US
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Telephone | 414-425-5841
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 5000425-015
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 5000425015
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License Number State | WI
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