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General NPI Number Information
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NPI Number | 1932406147
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Entity Type | Individual
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Provider Name | HUBERT ERIC HEIDEN D.D.S
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Gender | Male
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Dates
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Enumeration Date | 02/24/2011
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Last Update Date | 04/26/2012
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Provider Practice Location Address
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Address Line | 2039 NORTH MAIN STREET
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City | SUMMERVILLE
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State | SC
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Zip | 29483
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Country | US
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Telephone | 843-871-0433
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Fax | 843-871-0476
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Provider Business Mailing Address
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Address Line | P.O. BOX 40068 THE HYGIENE CENTER
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City | NORTH CHARLESTON
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State | SC
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Zip | 29423-0068
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Country | US
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Telephone | 843-871-0433
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Fax | 843-871-0476
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 1100
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License Number State | SC
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