Individual
DR. DALLIN HEINER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
244 E MAIN ST, REXBURG, ID 83440-2022
(208) 359-1880
(208) 359-2025
Mailing address
244 E MAIN ST, REXBURG, ID 83440-2022
(208) 359-1880
(208) 359-2025
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODP 100060
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010147628
REGENCE BLUE SHIELD OF ID
ID
05
—
806951300
—
ID
01
—
857241
DESERET MUTUAL
ID
01
—
V6515
BLUE CROSS OF IDAHO
ID
Enumeration date
08/23/2006
Last updated
09/24/2008
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