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General NPI Number Information
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NPI Number | 1154456283
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Entity Type | Individual
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Provider Name | EDWARD C HERMAN DDS
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Gender | Male
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 111 W JOHNSTOWN RD SUITE A
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City | GAHANNA
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State | OH
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Zip | 43230-2714
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Country | US
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Telephone | 614-471-5090
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Fax |
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Provider Business Mailing Address
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Address Line | 13525 JUG ST RD NW
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City | JOHNSTOWN
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State | OH
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Zip | 43031-8504
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Country | US
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Telephone | 740-967-1367
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 30017351
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License Number State | OH
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