Provider Demographics
NPI:1326042847
Name:SPROWLS, HEIDI F (DDS)
Entity Type:Individual
Prefix:DR
First Name:HEIDI
Middle Name:F
Last Name:SPROWLS
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 1:7083 CORPORATE WAY
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45459-4223
Mailing Address - Country:US
Mailing Address - Phone:937-434-1151
Mailing Address - Fax:937-434-0698
Practice Address - Street 1:7083 CORPORATE WAY
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45459-4223
Practice Address - Country:US
Practice Address - Phone:937-434-1151
Practice Address - Fax:937-434-0698
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-13
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300215201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice