Provider Demographics
NPI:1700041985
Name:KOVAR, HEIDI H (DDS)
Entity Type:Individual
Prefix:DR
First Name:HEIDI
Middle Name:H
Last Name:KOVAR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 E UFER ST
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78624-4141
Mailing Address - Country:US
Mailing Address - Phone:830-997-7544
Mailing Address - Fax:830-990-8954
Practice Address - Street 1:104 E UFER ST
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:TX
Practice Address - Zip Code:78624-4141
Practice Address - Country:US
Practice Address - Phone:830-997-7544
Practice Address - Fax:830-990-8954
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-27
Last Update Date:2008-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX212821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice