Healthcare Provider Details

I. General information

NPI: 1265780696
Provider Name (Legal Business Name): HEATHER MARIE BROOKS DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HEATHER MARIE HOWELL DDS, MS, ABGD

II. Dates (important events)

Enumeration Date: 08/15/2012
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 TWINING ST BLDG 760
MAXWELL AFB AL
36112-6027
US

IV. Provider business mailing address

300 TWINING ST BLDG 760
MAXWELL AFB AL
36112-6027
US

V. Phone/Fax

Practice location:
  • Phone: 334-953-5200
  • Fax: 334-953-8607
Mailing address:
  • Phone: 334-953-5200
  • Fax: 334-953-8607

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number0401413661
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: