Provider Demographics
NPI:1275552838
Name:HEINBACH, LAWRENCE (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:
Last Name:HEINBACH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:680 FOX HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-4449
Mailing Address - Country:US
Mailing Address - Phone:215-493-9823
Mailing Address - Fax:
Practice Address - Street 1:1130 N. ROUTE 130
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08016
Practice Address - Country:US
Practice Address - Phone:609-387-4333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ102261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice