Provider Demographics
NPI:1265416069
Name:LEWIS HEYWOOD, BARBARA V (DMD)
Entity type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:V
Last Name:LEWIS HEYWOOD
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 1:5721 4TH ST NW
Mailing Address - Street 2:PERFECT TEETH FOURTH STREET PC
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87107-5302
Mailing Address - Country:US
Mailing Address - Phone:505-345-0515
Mailing Address - Fax:505-345-2418
Practice Address - Street 1:5721 4TH ST NW
Practice Address - Street 2:PERFECT TEETH FOURTH STREET PC
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107-5302
Practice Address - Country:US
Practice Address - Phone:505-345-0515
Practice Address - Fax:505-345-2418
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD26821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice