Individual
DR. HEATHER LOUISE PHARES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
4711 FIRST STREET, NEW ERA, MI 49446
(231) 861-5905
(231) 861-4764
Mailing address
4711 FIRST STREET, NEW ERA, MI 49446
(231) 861-5905
(231) 861-4764
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
017662
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1810072
UNITED CONCORDIA
MI
01
—
D176620
BLUE CROSS BLUE SHIELD
MI
Enumeration date
10/05/2006
Last updated
07/08/2007
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