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General NPI Number Information
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NPI Number | 1417630500
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Entity Type | Organization
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Legal Business Name | HEYSE ENDODONTICS PLLC
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Dates
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Enumeration Date | 08/07/2023
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Last Update Date | 08/07/2023
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Provider Practice Location Address
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Address Line | 2373 CENTRAL PARK BLVD UNIT 203
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City | DENVER
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State | CO
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Zip | 80238-2300
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Country | US
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Telephone | 720-594-1024
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Fax |
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Provider Business Mailing Address
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Address Line | 1638 POPLAR ST
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City | DENVER
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State | CO
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Zip | 80220-1837
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Country | US
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Telephone | 702-336-8569
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JEFFREY DAVID HEYSE JR.
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Credential | DMD
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Telephone | 720-594-1024
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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