Provider Demographics
NPI:1497929426
Name:M. JUNE HIEBERT DDS, PC
Entity Type:Organization
Organization Name:M. JUNE HIEBERT DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:JUNE
Authorized Official - Last Name:HIEBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-227-4464
Mailing Address - Street 1:414 E STATE RD
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:OK
Mailing Address - Zip Code:73737-1330
Mailing Address - Country:US
Mailing Address - Phone:580-227-4464
Mailing Address - Fax:580-227-4465
Practice Address - Street 1:414 E STATE RD
Practice Address - Street 2:
Practice Address - City:FAIRVIEW
Practice Address - State:OK
Practice Address - Zip Code:73737-1330
Practice Address - Country:US
Practice Address - Phone:580-227-4464
Practice Address - Fax:580-227-4465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-22
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK47571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty