Provider Demographics
NPI:1174834410
Name:HEIDER, ALLISON LEIGH (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:LEIGH
Last Name:HEIDER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:988 W 3RD ST STE 202
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52001-6666
Mailing Address - Country:US
Mailing Address - Phone:563-557-7560
Mailing Address - Fax:563-557-7561
Practice Address - Street 1:988 W 3RD ST STE 202
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-6666
Practice Address - Country:US
Practice Address - Phone:635-577-5605
Practice Address - Fax:563-557-7561
Is Sole Proprietor?:No
Enumeration Date:2010-07-01
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA08729122300000X, 1223G0001X
IL019030377122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist