Provider Demographics
NPI:1851511323
Name:HEISE, NUPUR NARAIN
Entity Type:Individual
Prefix:DR
First Name:NUPUR
Middle Name:NARAIN
Last Name:HEISE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NUPUR
Other - Middle Name:
Other - Last Name:NARAIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:47 CLAPBOARD HILL RD STE 3
Mailing Address - Street 2:
Mailing Address - City:GUILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06437-2282
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:47 CLAPBOARD HILL RD STE 3
Practice Address - Street 2:
Practice Address - City:GUILFORD
Practice Address - State:CT
Practice Address - Zip Code:06437-2282
Practice Address - Country:US
Practice Address - Phone:203-458-1992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT7633122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist