Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223P0700X | Prosthodontist | 4730 | WI |
N | 1223P0700X | Prosthodontist | AA813 | AK |
Y | 1223P0700X | Prosthodontist | D11288 | MN |
NPI | 1164863064 |
---|---|
Provider Name | Dr. Donna Marie Hecker |
First Address | Chanhassen, MN 55317-9314 |
Second Address | Chanhassen, MN 55317-9314 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2013 |
Last Update Date | 09/07/2013 |