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NPI 1104847292

NPI 1104847292 : HERMAN STRATING D.M.D. : BEVERLY, MA

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General NPI Number Information
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    NPI Number           |    1104847292
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    Entity Type          |    Individual 
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    Provider Name        |    HERMAN STRATING D.M.D.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    07/22/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    16 ENON ST 
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    City                 |    BEVERLY
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    State                |    MA
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    Zip                  |    01915-1116
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    Country              |    US
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    Telephone            |    978-922-6726
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    Fax                  |    978-922-6727
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Provider Business Mailing Address
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    Address Line         |    16 ENON ST 
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    City                 |    BEVERLY
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    State                |    MA
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    Zip                  |    01915-1116
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    Country              |    US
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    Telephone            |    978-922-6726
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    Fax                  |    978-922-6727
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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        |    1223P0700X
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    Taxonomy Name        |    Prosthodontics
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    License Number       |    17559
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    License Number State |    MA
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