Organization
HERITAGE FAMILY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NISSA MCCONNELL (OWNER/DENTIST)
(812) 476-3002
Entity
Organization
Contact information
Practice address
731 N GREEN RIVER RD, EVANSVILLE, IN 47715-2415
(812) 476-3002
(812) 476-3027
Mailing address
731 N GREEN RIVER RD, EVANSVILLE, IN 47715-2415
(812) 476-3002
(812) 476-3027
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12011723A
IN
Other
Enumeration date
01/30/2012
Last updated
01/30/2012
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