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Individual

WILLIAM TYLER HEATH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.M.D.

Contact information

Practice address
1107 LOUISA ST, RAYVILLE, LA 71269-2925
(318) 728-9585
(318) 728-9595
Mailing address
1107 LOUISA ST, RAYVILLE, LA 71269-2925
(318) 728-9585
(318) 728-9595

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5110
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1851108
LA
Enumeration date
06/18/2006
Last updated
09/10/2012
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