Healthcare Provider Details

I. General information

NPI: 1043288947
Provider Name (Legal Business Name): DOUGLAS A HELLER D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 S PEORIA ST BUILDING D
AURORA CO
80014-3182
US

IV. Provider business mailing address

2900 S PEORIA ST BUILDING D
AURORA CO
80014-3182
US

V. Phone/Fax

Practice location:
  • Phone: 303-755-4500
  • Fax: 303-755-4047
Mailing address:
  • Phone: 303-755-4500
  • Fax: 303-755-4047

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number6832
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: