Provider Demographics
NPI:1497885032
Name:THOMAS H HEFLIN DDS PA
Entity Type:Organization
Organization Name:THOMAS H HEFLIN DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:H
Authorized Official - Last Name:HEFLIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:505-883-0323
Mailing Address - Street 1:8000 CARMEL AVENUE NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87122
Mailing Address - Country:US
Mailing Address - Phone:505-883-0323
Mailing Address - Fax:505-884-5471
Practice Address - Street 1:8000 CARMEL AVENUE NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87122
Practice Address - Country:US
Practice Address - Phone:505-883-0323
Practice Address - Fax:505-884-5471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1117122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty