Provider Demographics
NPI:1619197944
Name:HEARTLAND DENTAL CARE OF OHIO, RICHARD E WORKMAN, DMD PS
Entity type:Organization
Organization Name:HEARTLAND DENTAL CARE OF OHIO, RICHARD E WORKMAN, DMD PS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:INS COOD
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:KROEGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-540-5100
Mailing Address - Street 1:690 MORRISON ROAD
Mailing Address - Street 2:SUITE B
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230
Mailing Address - Country:US
Mailing Address - Phone:614-575-6404
Mailing Address - Fax:614-575-6401
Practice Address - Street 1:690 MORRISON ROAD
Practice Address - Street 2:SUITE B
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230
Practice Address - Country:US
Practice Address - Phone:614-575-6404
Practice Address - Fax:614-575-6401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty