Individual
DR. GERALD HEIM
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1200 MAIN ST, LA CROSSE, WI 54601-4102
(608) 782-6778
(608) 782-6561
Mailing address
1200 MAIN ST, LA CROSSE, WI 54601-4102
(608) 782-6778
(608) 782-6561
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
5000855-015
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33560200
—
WI
Enumeration date
05/27/2006
Last updated
07/08/2007
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