Individual
DR. BRIAN TORY HEINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2850 LONE OAK RD STE #6, PADUCAH, KY 42003-8043
(270) 554-2026
(270) 554-2028
Mailing address
2850 LONE OAK RD STE #6, PADUCAH, KY 42003-8043
(270) 554-2026
(270) 554-2028
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
6942
KY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
6942
KY
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
6942
KY
Other
Enumeration date
11/16/2006
Last updated
10/14/2015
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