Provider Demographics
NPI:1841628856
Name:HERBERT S WOODWARD III DDS INC
Entity type:Organization
Organization Name:HERBERT S WOODWARD III DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HERBERT
Authorized Official - Middle Name:STARR
Authorized Official - Last Name:WOODWARD
Authorized Official - Suffix:III
Authorized Official - Credentials:DDS
Authorized Official - Phone:760-729-7901
Mailing Address - Street 1:325 CARLSBAD VILLAGE DR
Mailing Address - Street 2:SUITE A-2
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-2928
Mailing Address - Country:US
Mailing Address - Phone:760-729-7901
Mailing Address - Fax:
Practice Address - Street 1:325 CARLSBAD VILLAGE DR
Practice Address - Street 2:SUITE A-2
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-2928
Practice Address - Country:US
Practice Address - Phone:760-729-7901
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-30
Last Update Date:2013-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30724261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental