MEDICARE: DR. HEATHER R FLOWERS D.M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	D10640	OR
2	122300000X	Dentist	D10640	OR

General Provider Information

NPI Number	:	1497278394
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HEATHER R FLOWERS D.M.D.

Provider Business Mailing Address
First Line	:	3173 NE WEST DEVILS LAKE ROAD
Second Line	:
City	:	LINCOLN CITY
State	:	OR
Zip	:	97367-5133
Country	:	US
Telephone Number	:	541-994-8135
Fax Number	:	541-994-8136

Provider Business Practice Location Address
First Line	:	3173 NE WEST DEVILS LAKE ROAD
Second Line	:
City	:	LINCOLN CITY
State	:	OR
Zip	:	97367-5133
Country	:	US
Telephone Number	:	541-994-8135
Fax Number	:	541-994-8136

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/23/2017
Last Update Date	:	09/22/2022

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