Most Relevant Information
Provider Data
| NPI Number: | 1003031824 |
| Provider Name: | GARY DAVID HEITZLER D.D.S. |
| Entity Type: | Individual |
| Taxonomy Code: | 1223P0221X |
| Specialty: | Dentist |
| License Number: | 044619 |
Most Important Dates
| Enumeration Date: | 04/16/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
615 BROADWAY
HASTINGS ON HUDSON
NY
107061039
Practice Location Phone/Fax
| Phone: | 9144788585 |
| Fax: | 9144785797 |
Provider Mailing Location
615 BROADWAY
HASTINGS ON HUDSON
NY
107061039
Provider Mailing Phone/Fax
| Phone: | 9144788585 |
| Fax: | 9144785797 |