Individual
DR. JAMES GREGORY HEFFERNAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
520 N 12TH STREET, VCU SCHOOL OF DENTISTRY, DEPT OF ENDODONTICS, RICHMOND, VA 23298-0566
(804) 828-1778
(804) 827-1373
Mailing address
403 WILLIAMSBURG AVE, GENEVA, IL 60134-1091
(630) 208-7668
(630) 208-7677
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
021001703
IL
1223E0200X
Endodontics
Primary
0411000054
VA
Other
Enumeration date
11/06/2006
Last updated
04/24/2020
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