Provider Demographics
NPI:1124111679
Name:HEINRICH, ROBERT BRIAN (DDS)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:BRIAN
Last Name:HEINRICH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10121 N NEVADA ST STE 302
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-3120
Mailing Address - Country:US
Mailing Address - Phone:506-467-1117
Mailing Address - Fax:506-467-1116
Practice Address - Street 1:10121 N NEVADA ST STE 302
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-3120
Practice Address - Country:US
Practice Address - Phone:506-467-1117
Practice Address - Fax:506-467-1116
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2012-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA71441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice