Individual
DR. DWIGHT DAVID HEBERER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
226 WESTVIEW PLAZA DR., WATERLOO, IL 62298-2123
(618) 939-4042
(618) 939-5404
Mailing address
16 BASS LN, BELLEVILLE, IL 62223-7626
(618) 476-7038
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
019020320
IL
332B00000X
Durable Medical Equipment & Medical Supplies
019020320
IL
332BC3200X
Customized Equipment (DME)
Primary
019020320
IL
Other
Enumeration date
11/15/2006
Last updated
11/21/2017
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