Provider Demographics
NPI:1033321468
Name:ROBERT M. HELLER, D.D.S., P.C.
Entity Type:Organization
Organization Name:ROBERT M. HELLER, D.D.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:M
Authorized Official - Last Name:HELLER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:248-642-5020
Mailing Address - Street 1:50 W BIG BEAVER RD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48304-3910
Mailing Address - Country:US
Mailing Address - Phone:248-642-5020
Mailing Address - Fax:248-642-9515
Practice Address - Street 1:50 W BIG BEAVER RD
Practice Address - Street 2:SUITE 120
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48304-3910
Practice Address - Country:US
Practice Address - Phone:248-642-5020
Practice Address - Fax:248-642-9515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-06
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI87671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty