Individual
BERT L HEISSER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
947 HALLOCK YOUNG RD SW, WARREN, OH 44481-9636
(330) 824-2515
Mailing address
947 HALLOCK YOUNG RD SW, WARREN, OH 44481-9636
(330) 824-2515
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
011820
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3812931
—
OH
Enumeration date
11/20/2006
Last updated
07/08/2007
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