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General NPI Number Information
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NPI Number | 1346469574
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Entity Type | Organization
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Legal Business Name | JOHN F. HERSCHLEB D.D.S., INC.
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Dates
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Enumeration Date | 04/25/2007
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Last Update Date | 06/23/2008
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Provider Practice Location Address
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Address Line | 1036 SIR FRANCIS DRAKE BLVD
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City | KENTFIELD
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State | CA
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Zip | 94904-1427
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Country | US
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Telephone | 415-456-5402
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Fax | 415-456-9275
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Provider Business Mailing Address
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Address Line | 1036 SIR FRANCIS DRAKE BLVD
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City | KENTFIELD
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State | CA
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Zip | 94904-1427
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Country | US
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Telephone | 415-456-5402
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Fax | 415-456-9275
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Authorized Official
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Title or Position | DENTIST
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Name | DR. JOHN FREDERICK HERSCHLEB
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Credential | D.D.S.
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Telephone | 415-456-5402
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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 | 25903
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License Number State | CA
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