Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 0401416581 | VA |
NPI | 1003478140 |
---|---|
Provider Name | Elizabeth Hubbard Hering |
First Address | Virginia Beach, VA 23452-5771 |
Second Address | Virginia Beach, VA 23452-5771 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2019 |
Last Update Date | 10/11/2021 |