Provider Demographics
NPI:1265607535
Name:HEARN, CLAUDE A (DMD, PA)
Entity type:Individual
Prefix:DR
First Name:CLAUDE
Middle Name:A
Last Name:HEARN
Suffix:
Gender:M
Credentials:DMD, PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:296 1ST ST N
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33881-4526
Mailing Address - Country:US
Mailing Address - Phone:863-294-2191
Mailing Address - Fax:863-294-3108
Practice Address - Street 1:296 1ST ST N
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33881-4526
Practice Address - Country:US
Practice Address - Phone:863-294-2191
Practice Address - Fax:863-294-3108
Is Sole Proprietor?:No
Enumeration Date:2008-04-28
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 130851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice