Provider Demographics
NPI:1033684071
Name:VOSKUHL, HEIDI (RDH)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:
Last Name:VOSKUHL
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:HEIDI
Other - Middle Name:
Other - Last Name:THORESEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10 E EASTERN AVE
Mailing Address - Street 2:
Mailing Address - City:LANSE
Mailing Address - State:MI
Mailing Address - Zip Code:49946-1208
Mailing Address - Country:US
Mailing Address - Phone:906-395-7770
Mailing Address - Fax:
Practice Address - Street 1:102 SUPERIOR AVE
Practice Address - Street 2:
Practice Address - City:BARAGA
Practice Address - State:MI
Practice Address - Zip Code:49908-9673
Practice Address - Country:US
Practice Address - Phone:906-353-4513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-05
Last Update Date:2018-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2902017788124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist