Provider Demographics
NPI:1326293416
Name:BACKUES, HEATHER (LDH)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:BACKUES
Suffix:
Gender:F
Credentials:LDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3326 ASPEN GROVE DR
Mailing Address - Street 2:SUITE 120
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-2837
Mailing Address - Country:US
Mailing Address - Phone:615-771-2151
Mailing Address - Fax:615-771-2161
Practice Address - Street 1:3326 ASPEN GROVE DR
Practice Address - Street 2:SUITE 120
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-2837
Practice Address - Country:US
Practice Address - Phone:615-771-2151
Practice Address - Fax:615-771-2161
Is Sole Proprietor?:No
Enumeration Date:2008-11-18
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDH0000006739124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist