Provider Demographics
NPI:1932406147
Name:HEIDEN, HUBERT ERIC (DDS)
Entity Type:Individual
Prefix:DR
First Name:HUBERT
Middle Name:ERIC
Last Name:HEIDEN
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:P.O. BOX 40068
Mailing Address - Street 2:THE HYGIENE CENTER
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29423-0068
Mailing Address - Country:US
Mailing Address - Phone:843-871-0433
Mailing Address - Fax:843-871-0476
Practice Address - Street 1:2039 NORTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29483
Practice Address - Country:US
Practice Address - Phone:843-871-0433
Practice Address - Fax:843-871-0476
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-24
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice