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Organization
W. TYLER HEATH, D.M.D., FAMILY DENTISTRY A DENT
Active
Organization
W. TYLER HEATH, D.M.D., FAMILY DENTISTRY A DENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM TYLER HEATH D.M.D. (OWNER/PRESIDENT)
(318) 728-9585
Entity
Organization
Contact information
Practice address
1107 LOUISA STREET, RAYVILLE, LA 71269
(318) 728-9585
(318) 728-9595
Mailing address
1107 LOUISA STREET, RAYVILLE, LA 71269
(318) 728-9585
(318) 728-9595
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5110
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1851108
—
LA
Enumeration date
08/11/2010
Last updated
08/11/2010
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