Provider Demographics
NPI:1962521880
Name:HERWIG, LARRY D VI
Entity type:Individual
Prefix:DR
First Name:LARRY
Middle Name:D
Last Name:HERWIG
Suffix:VI
Gender:M
Credentials:
Other - Prefix:
Other - First Name:LARRY
Other - Middle Name:D
Other - Last Name:HERWIG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:8411 PRESTON RD #850
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225
Mailing Address - Country:US
Mailing Address - Phone:214-361-1845
Mailing Address - Fax:
Practice Address - Street 1:8411 PRESTON RD #850
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75225
Practice Address - Country:US
Practice Address - Phone:214-361-1845
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX141941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice