Healthcare Provider Details
I. General information
NPI: 1689724312
Provider Name (Legal Business Name): KARL V HEUER DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 01/12/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
313 S MAIN ST
ALBION NY
14411-1602
US
IV. Provider business mailing address
313 S MAIN ST
ALBION NY
14411-1602
US
V. Phone/Fax
- Phone: 585-589-4325
- Fax:
- Phone: 585-589-4325
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 122300000X |
| Taxonomy | Dentist |
| License Number | 031653 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: