Provider Demographics
NPI:1679687701
Name:HECK, MICHELLE YVONNE (DMD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:YVONNE
Last Name:HECK
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 1:470 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT ORAB
Mailing Address - State:OH
Mailing Address - Zip Code:45154-9452
Mailing Address - Country:US
Mailing Address - Phone:937-444-3311
Mailing Address - Fax:937-444-1720
Practice Address - Street 1:470 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MOUNT ORAB
Practice Address - State:OH
Practice Address - Zip Code:45154-9452
Practice Address - Country:US
Practice Address - Phone:937-444-3311
Practice Address - Fax:937-444-1720
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH20459122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist