Individual
DAVID E. HEISEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
240 PARSONS AVE, COLUMBUS, OH 43215-5331
(614) 645-7417
Mailing address
240 PARSONS AVE, COLUMBUS, OH 43215-5331
(614) 645-7417
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
30.014950
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0436291
—
OH
05
—
0616622
—
OH
01
—
316400223035
CARESOURCE GROUP #
OH
Enumeration date
10/20/2006
Last updated
07/17/2007
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