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PETER J HEATH, D.D.S., M.D. – NPI #1396738746
Oral & Maxillofacial Surgery

NPI Profile for Dr PETER J HEATH in MISHAWAKA, IN.

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Contact Information

PETER J HEATH, D.D.S., M.D.
270 E DAY RD
SUITE 260
MISHAWAKA, IN  46545-3444
 Phone: 574-272-8823
 Fax: 574-277-1837
 Website:
 

Specialty

 Taxonomy Code Specialty Code Provider Type

Oral & Maxillofacial Surgery

 204E00000X 02 Physician/General Surgery
 

Oral and Maxillofacial Surgery

 1223S0112X 19 Oral Surgery (Dentist only)
Indicates primary specialty

NPI Profile & details for PETER J HEATH · (Male)

NPI Number 1396738746
Status Active
Credentials D.D.S., M.D.
Entity Individual
Enumeration date 08/31/2005
Last updated 09/29/2015 - About 11 years ago
Sole proprietor 1 No
Identifiers
  • LA License # 12434R
  • MD License # 9545
  • NH License # 2503
  • IN Medicaid 200870900
  • IN Other 12011044A IN DENTAL LICENSE
  • IN Other 01063978A IN MEDICAL LICENSE
  • LA Other 12434R MEDICAL LICENSE
  • MD Other 9545 DENTAL LICENSE
  • NH Other 2503 DENTAL LICENSE (INACTIVE)
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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