Provider Demographics
NPI:1497239297
Name:DENNIS J. HERITIER DDS P.C.
Entity Type:Organization
Organization Name:DENNIS J. HERITIER DDS P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:JEROME
Authorized Official - Last Name:HERITIER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:317-255-5285
Mailing Address - Street 1:6284 RUCKER RD STE G
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46220-4851
Mailing Address - Country:US
Mailing Address - Phone:317-255-5285
Mailing Address - Fax:317-255-0548
Practice Address - Street 1:6284 RUCKER RD STE G
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46220-4851
Practice Address - Country:US
Practice Address - Phone:317-255-5285
Practice Address - Fax:317-255-0548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-18
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental