Individual
DR. KORT HERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
4971 S STATE RTE 159, MARYVILLE, IL 62062
(618) 288-6699
Mailing address
4971 S STATE RTE 159, MARYVILLE, IL 62062
(618) 288-6699
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0190276771
IL
Other
Enumeration date
06/23/2008
Last updated
06/23/2008
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