DR. Travis Glenn Heaton, DDS

NPI #1265783310 in Tyler, Texas

Provider Information

NPI Number: 1265783310
Entity Type: Individual
Name: DR. Travis Glenn Heaton, DDS
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist - General Practice
Credential: DDS
Enumeration Date: Sep 28, 2012
Last Updated: Sep 28, 2012

Practice Location

Address: 4700 KINSEY DR
City: Tyler
State: Texas
ZIP Code: 75703-1009
Phone: (903) 245-9413

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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