Provider Demographics
NPI:1235161514
Name:EGGERS-ULVE, HEIDI (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:HEIDI
Middle Name:
Last Name:EGGERS-ULVE
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 S WEBSTER AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54301-2281
Mailing Address - Country:US
Mailing Address - Phone:920-432-2961
Mailing Address - Fax:920-432-2974
Practice Address - Street 1:1901 S WEBSTER AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54301-2281
Practice Address - Country:US
Practice Address - Phone:920-432-2961
Practice Address - Fax:920-432-2974
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4624-0151223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry