Individual
DR. ANDREW P HEISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
DS028299L
PA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DS028299L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1730880
—
PA
01
—
32271
BLUE SHIELD IDENTIFICATIO
PA
01
—
DS028299L
DENTAL LICENSE
PA
Enumeration date
01/26/2006
Last updated
09/11/2025
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