# HEATH DENTAL, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962895201
- **Authorized official:** DR. DAVID HARRISON HEATH D.D.S. (DENTIST)
- **Authorized official phone:** (317) 892-4994

## Contact information

- **Practice address:** 204 N MAPLE ST, PITTSBORO, IN 46167-9164
- **Practice address phone:** (317) 892-4994
- **Mailing address:** 204 N MAPLE ST, P.O. BOX 314, PITTSBORO, IN 46167-9164
- **Mailing address phone:** (317) 892-4994

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 12012135A | IN | Yes |

## Other

- **Enumeration date:** 03/11/2015
- **Last updated:** 03/11/2015