Individual
DR. JACQUELINE HEATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
515 DELAWARE ST SE, MINNEAPOLIS, MN 55455-0357
(612) 625-6444
Mailing address
1934 17TH ST S, SAINT CLOUD, MN 56301-4915
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
R696
MN
Other
Enumeration date
09/07/2017
Last updated
09/07/2017
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