Provider Demographics
NPI:1194718031
Name:HERRIN, JOHN R (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:R
Last Name:HERRIN
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 S RIVER RD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-6941
Mailing Address - Country:US
Mailing Address - Phone:603-624-8787
Mailing Address - Fax:603-624-7944
Practice Address - Street 1:170 S RIVER RD
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6941
Practice Address - Country:US
Practice Address - Phone:603-624-8787
Practice Address - Fax:603-624-7944
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-25
Last Update Date:2007-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH20631223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics