Provider Demographics
NPI:1912116526
Name:HEERING, DAVID BRIAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:BRIAN
Last Name:HEERING
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2115 KLOCKNER RD
Mailing Address - Street 2:
Mailing Address - City:HAMILTON SQUARE
Mailing Address - State:NJ
Mailing Address - Zip Code:08690-3403
Mailing Address - Country:US
Mailing Address - Phone:609-588-8222
Mailing Address - Fax:
Practice Address - Street 1:2115 KLOCKNER RD
Practice Address - Street 2:
Practice Address - City:HAMILTON SQUARE
Practice Address - State:NJ
Practice Address - Zip Code:08690-3403
Practice Address - Country:US
Practice Address - Phone:609-588-8222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI018324001223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics