Individual
DR. MATTHEW L HEAPHY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
712 KENSINGTON AVE, MISSOULA, MT 59801-5720
(406) 543-8347
(406) 543-8650
Mailing address
712 KENSINGTON AVE, MISSOULA, MT 59801-5720
(406) 543-8347
(406) 543-8650
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2081
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2081
STATE LICENSE
MT
Enumeration date
11/15/2006
Last updated
07/08/2007
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