Individual
DR. JONATHAN K HEATON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
703 N DUSTIN AVE, FARMINGTON, NM 87401-6101
(505) 564-9700
Mailing address
703 N DUSTIN AVE, FARMINGTON, NM 87401-6101
(505) 564-9700
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
D4376
ID
1223G0001X
General Practice Dentistry
Primary
DD3766
NM
Other
Enumeration date
09/16/2011
Last updated
03/28/2015
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