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General NPI Number Information
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NPI Number | 1740976398
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Entity Type | Organization
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Legal Business Name | HEDDAEUS DENTAL LLC
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Dates
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Enumeration Date | 04/17/2023
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Last Update Date | 04/17/2023
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Provider Practice Location Address
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Address Line | 3435 US HIGHWAY 9
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City | FREEHOLD
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State | NJ
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Zip | 07728-3285
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Country | US
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Telephone | 732-702-2936
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Fax |
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Provider Business Mailing Address
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Address Line | 6 BARBERA DR
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City | HOLMDEL
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State | NJ
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Zip | 07733-2800
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | WILLIAM HEDDAEUS
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Credential | DMD
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Telephone | 732-702-2936
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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 |
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License Number State |
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