Individual
DR. HEIDI KOHLTFARBER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
239 SOUTH BEND DR., DURHAM, NC 27713
(909) 731-1176
(909) 558-4477
Mailing address
LLUSD ODRP DEPT, 11092 ANDERSON ST., LOMA LINDA, CA 92350-0001
(909) 558-4602
(909) 558-4477
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
51273
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51273
DENTAL LICENSE
CA
Enumeration date
12/19/2006
Last updated
06/22/2009
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