Provider Demographics
NPI:1578175915
Name:HEFELE, ANNE ELIZABETH (DMD)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:ELIZABETH
Last Name:HEFELE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 VIRGINIA ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:VA
Mailing Address - Zip Code:23005-2049
Mailing Address - Country:US
Mailing Address - Phone:804-798-8019
Mailing Address - Fax:
Practice Address - Street 1:200 VIRGINIA ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:VA
Practice Address - Zip Code:23005-2049
Practice Address - Country:US
Practice Address - Phone:804-798-8019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-18
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014171231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice