Individual
EVAN HERTAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MSD
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
059074
NY
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
059074
NY
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
22D102865200
NJ
Other
Enumeration date
06/04/2015
Last updated
06/30/2022
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