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General NPI Number Information
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NPI Number | 1760552038
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Entity Type | Organization
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Legal Business Name | CRAIG M HESCHELES DMD PA
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 03/04/2016
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Provider Practice Location Address
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Address Line | 8190 JOG RD STE 210
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City | BOYNTON BEACH
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State | FL
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Zip | 33472-2914
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Country | US
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Telephone | 561-752-8640
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Fax |
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Provider Business Mailing Address
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Address Line | 8190 JOG RD STE 210
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City | BOYNTON BEACH
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State | FL
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Zip | 33472-2914
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Country | US
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Telephone | 561-752-8640
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Fax |
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. CRAIG M HESCHELES
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Credential | DMD
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Telephone | 561-752-8640
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 14588
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License Number State | FL
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