=====================================================
General NPI Number Information
=====================================================
NPI Number | 1578741088
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DAVID B HEYS D.D.S.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/06/2008
-----------------------------------------------------
Last Update Date | 07/15/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 38000 ANN ARBOR TRAIL
-----------------------------------------------------
City | LIVONIA
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48150-2453
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 734-591-3636
-----------------------------------------------------
Fax | 734-591-3355
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2770 BEDFORD RD
-----------------------------------------------------
City | ANN ARBOR
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48104-4012
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 734-945-6230
-----------------------------------------------------
Fax | 734-945-6230
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number | 2901019588
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------