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General NPI Number Information
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NPI Number | 1386718906
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Entity Type | Individual
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Provider Name | HERMAN LARRY WALDMAN DDS
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Gender | Male
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Dates
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Enumeration Date | 11/17/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 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 |
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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 | 22D100869600
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License Number State | NJ
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