Individual
DR. ROBERT HEIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
9775 SE SUNNYSIDE RD, 200, CLACKAMAS, OR 97015-5739
(503) 655-8471
(503) 723-4907
Mailing address
2051 KAEN RD, 367, OREGON CITY, OR 97045-4035
(503) 650-3110
(503) 742-5979
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
30015652
OH
122300000X
Dentist
Primary
D8746
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
099071
—
OH
05
—
168395
—
OR
01
—
D8746
STATE LICENCE NUMBER
OR
01
—
R103163
MEDICARE PART B
—
Enumeration date
08/31/2006
Last updated
02/28/2017
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