Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 18905 | OH |
NPI | 1093846214 |
---|---|
Provider Name | Dr. Robert Louis Heller |
First Address | Columbus, OH 43221 |
Second Address | Lewis Center, OH 43035 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2007 |
Last Update Date | 08/07/2007 |