Individual
DR. MARK JOSEPH HEENAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
725 MIAMI ST, TOLEDO, OH 43605-2278
(419) 693-4712
(419) 693-4495
Mailing address
725 MIAMI ST, TOLEDO, OH 43605-2278
(419) 693-4712
(419) 693-4495
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
17029
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04944
PARAMOUNT
OH
05
—
2618984
—
OH
Enumeration date
08/27/2006
Last updated
10/26/2016
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