Provider Demographics
NPI:1134215783
Name:RECHTIN, HEATHER ELIZABETH (DDS)
Entity type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:ELIZABETH
Last Name:RECHTIN
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 1:12672 ALSWELL LN
Mailing Address - Street 2:
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63128
Mailing Address - Country:US
Mailing Address - Phone:314-729-0094
Mailing Address - Fax:
Practice Address - Street 1:3450 BRIDGELAND DR
Practice Address - Street 2:SUITE A
Practice Address - City:BRIDGETON
Practice Address - State:MO
Practice Address - Zip Code:63044
Practice Address - Country:US
Practice Address - Phone:314-770-0400
Practice Address - Fax:314-770-0170
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2000157415122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist