MEDICARE: DR. ROBERT HEIL DDS

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	5139	WI

General Provider Information

NPI Number	:	1528071990
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT HEIL DDS

Provider Business Mailing Address
First Line	:	623 E TALLGRASS DR
Second Line	:
City	:	APPLETON
State	:	WI
Zip	:	54913-7505
Country	:	US
Telephone Number	:	920-428-5416
Fax Number	:

Provider Business Practice Location Address
First Line	:	1013 N MAIN ST
Second Line	:
City	:	OSHKOSH
State	:	WI
Zip	:	54901-3837
Country	:	US
Telephone Number	:	920-428-5416
Fax Number	:

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

Provider Enumeration Date	:	08/15/2006
Last Update Date	:	01/07/2022

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Directions to “ DR. ROBERT HEIL DDS” Practice Location

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