Provider Demographics
NPI:1801885207
Name:ROMNEY, HEIDI RENEE (DMD)
Entity type:Individual
Prefix:DR
First Name:HEIDI
Middle Name:RENEE
Last Name:ROMNEY
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 1:123 SE DOUGLAS ST
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:OR
Mailing Address - Zip Code:97365-4426
Mailing Address - Country:US
Mailing Address - Phone:541-265-4221
Mailing Address - Fax:541-574-6552
Practice Address - Street 1:123 SE DOUGLAS ST
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:OR
Practice Address - Zip Code:97365-4426
Practice Address - Country:US
Practice Address - Phone:541-265-4221
Practice Address - Fax:541-574-6552
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD7091122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist