MEDICARE: DR. MARIE LOUISA HESKE DMD

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	122300000X	Dentist	8187	NV

General Provider Information

NPI Number	:	1922792084
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIE LOUISA HESKE DMD

Provider Business Mailing Address
First Line	:	3015 HIGHWAY 95 STE 112
Second Line	:
City	:	BULLHEAD CITY
State	:	AZ
Zip	:	86442-4334
Country	:	US
Telephone Number	:	928-758-0008
Fax Number	:

Provider Business Practice Location Address
First Line	:	8925 W RUSSELL RD STE 160
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-1220
Country	:	US
Telephone Number	:	725-330-7825
Fax Number	:

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

Provider Enumeration Date	:	06/02/2023
Last Update Date	:	01/12/2026

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