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General NPI Number Information
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NPI Number | 1497929426
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Entity Type | Organization
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Legal Business Name | M. JUNE HIEBERT DDS, PC
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Dates
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Enumeration Date | 04/22/2008
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Last Update Date | 04/22/2008
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Provider Practice Location Address
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Address Line | 414 E STATE RD
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City | FAIRVIEW
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State | OK
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Zip | 73737-1330
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Country | US
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Telephone | 580-227-4464
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Fax | 580-227-4465
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Provider Business Mailing Address
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Address Line | 414 E STATE RD
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City | FAIRVIEW
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State | OK
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Zip | 73737-1330
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Country | US
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Telephone | 580-227-4464
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Fax | 580-227-4465
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Authorized Official
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Title or Position | DENTIST
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Name | DR. MARILYN JUNE HIEBERT
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Credential |
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Telephone | 580-227-4464
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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 | 4757
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License Number State | OK
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