Provider Demographics
NPI:1871824250
Name:THIEMS-HEFLIN, SUZANNE (DMD)
Entity Type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:
Last Name:THIEMS-HEFLIN
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 1:210 NW 75TH DR
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-6530
Mailing Address - Country:US
Mailing Address - Phone:352-331-7213
Mailing Address - Fax:352-336-6903
Practice Address - Street 1:210 NW 75TH DR
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-6530
Practice Address - Country:US
Practice Address - Phone:352-331-7213
Practice Address - Fax:352-336-6903
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-25
Last Update Date:2010-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN0011169122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist