Provider Demographics
NPI:1538474572
Name:HEGGIE, STEPHEN TURNER (DMD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:TURNER
Last Name:HEGGIE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3023 THOUSAND OAKS DR STE 110
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78247-3557
Mailing Address - Country:US
Mailing Address - Phone:210-497-6700
Mailing Address - Fax:210-497-6706
Practice Address - Street 1:3023 THOUSAND OAKS DR STE 110
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78247-3557
Practice Address - Country:US
Practice Address - Phone:210-497-6700
Practice Address - Fax:210-497-6706
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-14
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDD-43091223G0001X
TX00262881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice