Individual
DR. CASEY BRIAN HEITZMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
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
3555-10
MS
Other
Enumeration date
07/09/2010
Last updated
11/09/2010
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