Provider Demographics
NPI:1568892610
Name:HEAP, JOSEPH CHASE (DMD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:CHASE
Last Name:HEAP
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 1:412 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BELGRADE
Mailing Address - State:MT
Mailing Address - Zip Code:59714-3828
Mailing Address - Country:US
Mailing Address - Phone:406-388-8006
Mailing Address - Fax:
Practice Address - Street 1:412 W MAIN ST STE 1
Practice Address - Street 2:
Practice Address - City:BELGRADE
Practice Address - State:MT
Practice Address - Zip Code:59714-3828
Practice Address - Country:US
Practice Address - Phone:406-388-8006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-26
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD3916122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist