Provider Demographics
NPI:1336135482
Name:HECK, LOWELL BARTON (DDS)
Entity Type:Individual
Prefix:DR
First Name:LOWELL
Middle Name:BARTON
Last Name:HECK
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 1:188 W HEBBLE AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRBORN
Mailing Address - State:OH
Mailing Address - Zip Code:45324-4960
Mailing Address - Country:US
Mailing Address - Phone:937-879-3579
Mailing Address - Fax:937-879-5331
Practice Address - Street 1:188 W HEBBLE AVE
Practice Address - Street 2:
Practice Address - City:FAIRBORN
Practice Address - State:OH
Practice Address - Zip Code:45324-4960
Practice Address - Country:US
Practice Address - Phone:937-879-3579
Practice Address - Fax:937-879-5331
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300149491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice