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Individual

TRENTON DAVIDHEISER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
1253 W PRATT ST, BALTIMORE, MD 21223-2684
(410) 727-4746
Mailing address
2221 E BIJOU ST STE 100, COLORADO SPRINGS, CO 80909-8009
(719) 576-1850

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
16992
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
16992
STATE LICENSE
MD
Enumeration date
07/10/2020
Last updated
07/10/2020
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