Provider Demographics
NPI:1205028156
Name:HEIT, ALAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:
Last Name:HEIT
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 1:903 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95060-3801
Mailing Address - Country:US
Mailing Address - Phone:831-423-3364
Mailing Address - Fax:831-423-3399
Practice Address - Street 1:903 CEDAR ST
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060-3801
Practice Address - Country:US
Practice Address - Phone:831-423-3364
Practice Address - Fax:831-423-3399
Is Sole Proprietor?:No
Enumeration Date:2007-08-14
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA305601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice