Mark Heideman, D.D.S
NPI 1891851358 · on the registry since 2006 · sole proprietor
Practice
- Address
- 920 E 5th St
Shawano, WI 54166 - Phone
- (715) 524-2581
- Organisation at this address
- Paul D. Dibley, D.D.S., S.C.
Inferred from a shared address, not stated in the registry.
Registry record
- Primary taxonomy
- Dentist
122300000X
- Licence states on file
- WI
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2007-07-08
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Wisconsin