Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 13623 | MA |
NPI | 1013176866 |
---|---|
Provider Name | Dr. William Hershberger |
First Address | Sudbury, MA 01776-2302 |
Second Address | Sudbury, MA 01776-2302 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2008 |
Last Update Date | 06/06/2008 |