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NPI 1063586691

NPI 1063586691 : HERMAN L WALDMAN DDS PA : MORRISTOWN, NJ

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General NPI Number Information
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    NPI Number           |    1063586691
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    Entity Type          |    Organization 
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    Legal Business Name  |    HERMAN L WALDMAN DDS PA 
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Dates
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    Enumeration Date     |    11/17/2006
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    Last Update Date     |    08/22/2020
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Provider Practice Location Address
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    Address Line         |    26 MADISON AVE 
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    City                 |    MORRISTOWN
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    State                |    NJ
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    Zip                  |    07960-7310
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    Country              |    US
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    Telephone            |    973-539-1434
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    Fax                  |    973-887-4364
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Provider Business Mailing Address
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    Address Line         |    26 MADISON AVE 
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    City                 |    MORRISTOWN
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    State                |    NJ
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    Zip                  |    07960-7310
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    Country              |    US
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    Telephone            |    973-539-1434
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    Fax                  |    973-887-4364
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Authorized Official
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    Title or Position    |    PRESIDENT
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    Name                 |    DR. HERMAN LARRY WALDMAN 
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    Credential           |    DDS
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    Telephone            |    973-539-1434
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1223G0001X
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    Taxonomy Name        |    General Practice Dentistry
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    License Number       |    22D100869600
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    License Number State |    NJ
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