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General NPI Number Information
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NPI Number | 1083934053
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Entity Type | Individual
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Provider Name | BENJAMIN J HECKMAN D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/01/2010
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Last Update Date | 02/19/2013
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Provider Practice Location Address
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Address Line | 117 BRYANT DR
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City | NICHOLASVILLE
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State | KY
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Zip | 40356
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Country | US
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Telephone | 859-885-0100
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Fax |
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Provider Business Mailing Address
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Address Line | 117 BRYANT DR
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City | NICHOLASVILLE
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State | KY
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Zip | 40356
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Country | US
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Telephone | 859-885-0100
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 8899
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 8899
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License Number State | KY
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