Organization
LESLIE J. HEINEMANN, DDS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LESLIE J. HEINEMANN DDS (CHAIRMAN)
(605) 997-3732
Entity
Organization
Contact information
Practice address
406 W PIPESTONE AVE, FLANDREAU, SD 57028-1617
(605) 997-3732
(605) 997-3799
Mailing address
406 W PIPESTONE AVE, PO BOX 191, FLANDREAU, SD 57028-1617
(605) 997-3732
(605) 997-3799
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7801660
—
SD
05
—
7803480
—
SD
Enumeration date
03/21/2007
Last updated
08/22/2020
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