Provider Demographics
NPI:1063496446
Name:HEATH, PAUL A (DDS)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:A
Last Name:HEATH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1601 SW 89TH ST
Mailing Address - Street 2:STE G500
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73159-6349
Mailing Address - Country:US
Mailing Address - Phone:405-682-0609
Mailing Address - Fax:405-682-2921
Practice Address - Street 1:1601 SW 89TH ST
Practice Address - Street 2:STE G500
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73159-6349
Practice Address - Country:US
Practice Address - Phone:405-682-0609
Practice Address - Fax:405-682-2921
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-30
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OKOK47211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice