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Individual

AMY HEIM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.D.S.

Contact information

Practice address
620 WASHINGTON ST, PORTSMOUTH, OH 45662-3920
(740) 354-5763
Mailing address
1235 DISTEL LN, PORTSMOUTH, OH 45662-6411
(614) 725-8801

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
30.024246
OH
390200000X
Student in an Organized Health Care Education/Training Program
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0106798
OH
Enumeration date
04/13/2013
Last updated
09/19/2014
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