Organization
BRYCE HEINER, DMD, MD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRYCE HEINER DMD, MD (CEO)
(575) 522-8800
Entity
Organization
Contact information
Practice address
2103 TELSHOR CT, LAS CRUCES, NM 88011-8245
(575) 522-8800
Mailing address
2103 TELSHOR CT, LAS CRUCES, NM 88011-8245
(575) 522-8800
(575) 522-8800
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
DD3068
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1386955888
GROUP NPI
—
Enumeration date
06/29/2010
Last updated
04/29/2022
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