Provider Demographics
NPI:1497278394
Name:FLOWERS, HEATHER R (DMD)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:R
Last Name:FLOWERS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:MISS
Other - First Name:HEATHER
Other - Middle Name:RENEE
Other - Last Name:HAINES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:3173 NE WEST DEVILS LAKE ROAD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97367-5133
Mailing Address - Country:US
Mailing Address - Phone:541-994-8135
Mailing Address - Fax:541-994-8136
Practice Address - Street 1:3173 NE WEST DEVILS LAKE ROAD
Practice Address - Street 2:
Practice Address - City:LINCOLN CITY
Practice Address - State:OR
Practice Address - Zip Code:97367-5133
Practice Address - Country:US
Practice Address - Phone:541-994-8135
Practice Address - Fax:541-994-8136
Is Sole Proprietor?:No
Enumeration Date:2017-07-23
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD106401223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice