Organization
ADVANCED DENTISTRY - HEFFERNAN DDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN HEFFERNAN DDS (MEMBER)
(614) 582-9617
Entity
Organization
Contact information
Practice address
1832 PEARL RD, BRUNSWICK, OH 44212-3252
(330) 460-3016
Mailing address
1832 PEARL RD, BRUNSWICK, OH 44212-3252
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1417217795
NPI
OH
Enumeration date
07/13/2021
Last updated
07/27/2021
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