Provider Demographics
NPI:1043398019
Name:HART, HEDDAMARIE UT (DMD)
Entity Type:Individual
Prefix:DR
First Name:HEDDAMARIE
Middle Name:UT
Last Name:HART
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8225 SAWMILL FALLS ST
Mailing Address - Street 2:
Mailing Address - City:N LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89085-4439
Mailing Address - Country:US
Mailing Address - Phone:702-304-8300
Mailing Address - Fax:702-304-8300
Practice Address - Street 1:8225 SAWMILL FALLS ST
Practice Address - Street 2:
Practice Address - City:N LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89085-4439
Practice Address - Country:US
Practice Address - Phone:702-304-8300
Practice Address - Fax:702-304-8300
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV45981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice