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General NPI Number Information
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NPI Number | 1114146206
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Entity Type | Organization
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Legal Business Name | HEIN DENTAL PROFESSIONAL LLC
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Dates
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Enumeration Date | 04/25/2007
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Last Update Date | 10/02/2007
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Provider Practice Location Address
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Address Line | 8200 E BELLEVIEW AVE SUITE 435 E
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City | GREENWOOD VILLAGE
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State | CO
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Zip | 80111-2803
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Country | US
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Telephone | 303-779-9472
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Fax | 303-779-4176
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Provider Business Mailing Address
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Address Line | 8200 E BELLEVIEW AVE SUITE 435 E
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City | GREENWOOD VILLAGE
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State | CO
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Zip | 80111-2803
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Country | US
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Telephone | 303-779-9472
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Fax | 303-779-4176
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Authorized Official
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Title or Position | DENTIST MEMBER-MANAGER
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Name | DR. THOMAS J HEIN
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Credential | DDS
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Telephone | 303-779-9472
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | H-D-1-04683
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License Number State | CO
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