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Organization

HEITZMANN DENTISTRY

Active
Other names
Magnolia family dental care
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CASEY BRIAN HEITZMANN DMD (DENTIST)
(601) 707-5585
Entity
Organization

Contact information

Practice address
207 W JACKSON ST STE B, RIDGELAND, MS 39157-2355
(601) 707-5585
(601) 707-5586
Mailing address
207 W JACKSON ST STE B, RIDGELAND, MS 39157-2355
(601) 707-5585
(601) 707-5586

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
355510
MS
1223P0221X
Pediatric Dentistry
349108
MS

Other

Enumeration date
12/09/2010
Last updated
12/09/2010
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