DR. Kenneth R Heise, DDS

NPI #1003905845 in Elysburg, Pennsylvania

Provider Information

NPI Number: 1003905845
Entity Type: Individual
Name: DR. Kenneth R Heise, DDS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: DDS
Enumeration Date: Oct 12, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 11 N MARKET ST
City: Elysburg
State: Pennsylvania
ZIP Code: 17824
Phone: (570) 672-9692

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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