Provider Demographics
NPI:1730386160
Name:FOSTER, HERBERT BRANDT (DDS)
Entity type:Individual
Prefix:DR
First Name:HERBERT
Middle Name:BRANDT
Last Name:FOSTER
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 1:2166 58TH AVE
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32966-4648
Mailing Address - Country:US
Mailing Address - Phone:443-838-0732
Mailing Address - Fax:
Practice Address - Street 1:2166 58TH AVENUE
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32966-4648
Practice Address - Country:US
Practice Address - Phone:443-838-0732
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 17866122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist