Provider Demographics
NPI:1346721206
Name:BICKEL, HEATHER (RDH)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:BICKEL
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:584 SPRINGVILLE RD
Mailing Address - Street 2:
Mailing Address - City:NEW HOLLAND
Mailing Address - State:PA
Mailing Address - Zip Code:17557-9564
Mailing Address - Country:US
Mailing Address - Phone:717-354-4711
Mailing Address - Fax:717-354-0284
Practice Address - Street 1:101 S 9TH ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-5108
Practice Address - Country:US
Practice Address - Phone:717-450-9015
Practice Address - Fax:717-273-2817
Is Sole Proprietor?:No
Enumeration Date:2018-08-28
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADH072933124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist