Provider Demographics
NPI:1447260617
Name:HERR, SID H (DDS)
Entity type:Individual
Prefix:DR
First Name:SID
Middle Name:H
Last Name:HERR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:937 JEFFCO BLVD
Mailing Address - Street 2:
Mailing Address - City:ARNOLD
Mailing Address - State:MO
Mailing Address - Zip Code:63010-1410
Mailing Address - Country:US
Mailing Address - Phone:636-296-6332
Mailing Address - Fax:636-287-6335
Practice Address - Street 1:937 JEFFCO BLVD
Practice Address - Street 2:
Practice Address - City:ARNOLD
Practice Address - State:MO
Practice Address - Zip Code:63010-1410
Practice Address - Country:US
Practice Address - Phone:636-296-6332
Practice Address - Fax:636-287-6335
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO331111041223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics