Provider Demographics
NPI:1497771042
Name:HEAPS, VINCENT HAROLD (DDS)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:HAROLD
Last Name:HEAPS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:543 LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:PA
Mailing Address - Zip Code:17512-1225
Mailing Address - Country:US
Mailing Address - Phone:717-684-4666
Mailing Address - Fax:717-684-2491
Practice Address - Street 1:543 LOCUST ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:PA
Practice Address - Zip Code:17512-1225
Practice Address - Country:US
Practice Address - Phone:717-684-4666
Practice Address - Fax:717-684-2491
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS019796L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist