MEDICARE: DR. WILLIAM CHARLES HEGGERICK DDS FACP

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	1223P0700X	Prosthodontics	DN11517	MA

General Provider Information

NPI Number	:	1851405120
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM CHARLES HEGGERICK DDS FACP

Provider Business Mailing Address
First Line	:	56 COLPITTS RD
Second Line	:
City	:	WESTON
State	:	MA
Zip	:	02493-1568
Country	:	US
Telephone Number	:	781-894-0347
Fax Number	:	781-894-0835

Provider Business Practice Location Address
First Line	:	56 COLPITTS RD
Second Line	:	WILLIAM C HEGGERICK DDS AND ASSOCIATES INC
City	:	WESTON
State	:	MA
Zip	:	02493-1568
Country	:	US
Telephone Number	:	781-894-0347
Fax Number	:	781-894-0835

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

Provider Enumeration Date	:	08/17/2006
Last Update Date	:	07/08/2007

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