Individual
DR. LESLIE JAMES HEINEMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
406 W PIPESTONE AVE, FLANDREAU, SD 57028-1617
(605) 997-3732
(605) 997-3799
Mailing address
406 W PIPESTONE AVE, FLANDREAU, SD 57028-1617
(605) 997-3732
(605) 997-3799
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
M-584
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
78-03480
—
SD
Enumeration date
12/04/2006
Last updated
07/08/2007
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