Provider Demographics
NPI:1376524652
Name:SOTTEK, HEIDI R (DDS)
Entity type:Individual
Prefix:DR
First Name:HEIDI
Middle Name:R
Last Name:SOTTEK
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 1:426 HALEY PL
Mailing Address - Street 2:
Mailing Address - City:PAGOSA SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:81147-7207
Mailing Address - Country:US
Mailing Address - Phone:615-830-7886
Mailing Address - Fax:
Practice Address - Street 1:1135 S CAMINO DEL RIO UNIT 220
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81303-6831
Practice Address - Country:US
Practice Address - Phone:970-247-0202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010186291223G0001X
TN93851223X0400X
CODEN.002033971223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No1223G0001XDental ProvidersDentistGeneral Practice