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General NPI Number Information
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NPI Number | 1457566358
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Entity Type | Individual
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Provider Name | DONALD WAYNE HERMANN DDS
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Gender | Male
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Dates
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Enumeration Date | 05/14/2007
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Last Update Date | 01/10/2012
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Provider Practice Location Address
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Address Line | 555 W. GRANADA BLVD SUITE E2
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City | ORMOND BEACH
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State | FL
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Zip | 32174
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Country | US
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Telephone | 386-672-5151
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Fax | 386-672-5313
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Provider Business Mailing Address
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Address Line | 555 W. GRANADA BLVD SUITE E2
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City | ORMOND BEACH
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State | FL
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Zip | 32174
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Country | US
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Telephone | 386-672-5151
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Fax | 386-672-5313
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 9626
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN9626
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License Number State | FL
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