Provider Demographics
NPI:1073600151
Name:HECK, DAVID L (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:L
Last Name:HECK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 E COURT ST
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-4221
Mailing Address - Country:US
Mailing Address - Phone:607-272-2033
Mailing Address - Fax:607-272-3757
Practice Address - Street 1:310 E COURT ST
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-4221
Practice Address - Country:US
Practice Address - Phone:607-272-2033
Practice Address - Fax:607-272-3757
Is Sole Proprietor?:No
Enumeration Date:2006-10-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0522951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice