Provider Demographics
NPI:1235558453
Name:HEATON HOLDINGS, PLLC
Entity Type:Organization
Organization Name:HEATON HOLDINGS, PLLC
Other - Org Name:MY FAMILY DENTIST GARLAND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BEVAN
Authorized Official - Middle Name:W
Authorized Official - Last Name:HEATON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:972-696-9273
Mailing Address - Street 1:1501 WEST MILLER RD.
Mailing Address - Street 2:SUITE 180
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75094
Mailing Address - Country:US
Mailing Address - Phone:972-696-9273
Mailing Address - Fax:
Practice Address - Street 1:1501 WEST MILLER RD.
Practice Address - Street 2:SUITE 180
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75094
Practice Address - Country:US
Practice Address - Phone:972-696-9273
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-15
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty