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Individual

KIRSTEN RAE HERTZOG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
101 S 9TH ST, LEBANON, PA 17042-5108
(717) 450-7015
(000) 000-0000
Mailing address
1819 OLD FARM LN, LANCASTER, PA 17602-4088
(717) 875-7627
(000) 000-0000

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS045393
PA

Other

Enumeration date
08/11/2025
Last updated
08/11/2025
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