Individual
DR. EMILY J VAN HEUKELOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
395 MAIN ST, UNIT 1, SALEM, NH 03079-2464
(603) 893-7601
Mailing address
395 MAIN ST, UNIT 1, SALEM, NH 03079-2464
(603) 893-7601
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
03719
NH
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
LIMITED # 9516
MA
Other
Enumeration date
04/28/2008
Last updated
07/28/2009
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