Individual
MARVIN HEINBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
10 E 9TH ST, SUITE C/D, LAWRENCE, KS 66044-2621
(785) 749-2525
(785) 749-9524
Mailing address
10 E 9TH ST, SUITE C/D, LAWRENCE, KS 66044-2621
(785) 749-2525
(785) 749-9524
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
60201
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1494001
UNITED CONCORDIA
KS
Enumeration date
07/14/2006
Last updated
07/08/2007
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