Provider Demographics
NPI:1467680306
Name:BETH HECKMAN D.D.S. L.L.C.
Entity Type:Organization
Organization Name:BETH HECKMAN D.D.S. L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BETH
Authorized Official - Middle Name:E
Authorized Official - Last Name:HECKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:913-707-3238
Mailing Address - Street 1:PO BOX 1436
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:KS
Mailing Address - Zip Code:67301-1436
Mailing Address - Country:US
Mailing Address - Phone:620-331-3580
Mailing Address - Fax:620-331-3587
Practice Address - Street 1:422 E MAIN ST
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:KS
Practice Address - Zip Code:67301-3716
Practice Address - Country:US
Practice Address - Phone:620-331-3580
Practice Address - Fax:620-331-3587
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-30
Last Update Date:2009-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS60674122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty