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NPI Code Detail

MEDICARE: DR. THOMAS JAMES HEINRICH D.D.S.

MEDICARE:  DR. THOMAS JAMES HEINRICH  D.D.S.
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
11223G0001XGeneral Practice Dentistry5000907-015WI

General Provider Information

NPI Number : 1740315373
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THOMAS JAMES HEINRICH D.D.S.
Provider Business Mailing Address
First Line : 4220 S 27TH ST
Second Line : SUITE 100
City : MILWAUKEE
State : WI
Zip : 53221-1855
Country : US
Telephone Number : 414-282-3340
Fax Number :
Provider Business Practice Location Address
First Line : 4220 S 27TH ST
Second Line : SUITE 100
City : MILWAUKEE
State : WI
Zip : 53221-1855
Country : US
Telephone Number : 414-282-3340
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2007
Last Update Date : 07/08/2007

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Directions to “ DR. THOMAS JAMES HEINRICH D.D.S.” Practice Location

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