Provider Demographics
NPI:1972591337
Name:HEILIG, JEFFREY P (DMD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:P
Last Name:HEILIG
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1040 WESTON RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-1978
Mailing Address - Country:US
Mailing Address - Phone:954-384-8888
Mailing Address - Fax:
Practice Address - Street 1:1040 WESTON RD
Practice Address - Street 2:SUITE 300
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-1978
Practice Address - Country:US
Practice Address - Phone:954-384-8888
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL90611223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry