Provider Demographics
NPI:1831288182
Name:HECK, BRIAN W (DDS)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:W
Last Name:HECK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4621 W 6TH ST STE B
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66049-4358
Mailing Address - Country:US
Mailing Address - Phone:785-856-0285
Mailing Address - Fax:785-856-2339
Practice Address - Street 1:4621 W 6TH ST STE B
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66049-4358
Practice Address - Country:US
Practice Address - Phone:785-856-0285
Practice Address - Fax:785-856-2339
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS600311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice