Provider Demographics
NPI:1962593434
Name:HEIN, ERIC ANDREW (DDS)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:ANDREW
Last Name:HEIN
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 1:2005 ROOSEVELT RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-2746
Mailing Address - Country:US
Mailing Address - Phone:219-531-5724
Mailing Address - Fax:219-531-0537
Practice Address - Street 1:2005 ROOSEVELT RD
Practice Address - Street 2:SUITE B
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-2746
Practice Address - Country:US
Practice Address - Phone:219-531-5724
Practice Address - Fax:219-531-0537
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12009868A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice