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General NPI Number Information
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NPI Number | 1902250954
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Entity Type | Organization
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Legal Business Name | ROBERT V. HERWIG, D.D.S., PA
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Dates
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Enumeration Date | 04/15/2016
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Last Update Date | 04/15/2016
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Provider Practice Location Address
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Address Line | 11900 W 87TH STREET PKWY SUITE 260
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City | LENEXA
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State | KS
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Zip | 66215-2807
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Country | US
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Telephone | 913-492-8884
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Fax | 913-492-4582
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Provider Business Mailing Address
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Address Line | 11900 W 87TH STREET PKWY SUITE 260
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City | LENEXA
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State | KS
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Zip | 66215-2807
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Country | US
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Telephone | 913-492-8884
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Fax | 913-492-4582
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. ROBERT V HERWIG
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Credential | D.D.S.
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Telephone | 913-492-8884
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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 | 5768
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License Number State | KS
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