Provider Demographics
NPI:1447699913
Name:HEATH, CAROL MCDONALD (DDS)
Entity type:Individual
Prefix:DR
First Name:CAROL
Middle Name:MCDONALD
Last Name:HEATH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 PRESTON ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-1419
Mailing Address - Country:US
Mailing Address - Phone:281-344-4527
Mailing Address - Fax:281-344-4581
Practice Address - Street 1:2100 PRESTON ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-1419
Practice Address - Country:US
Practice Address - Phone:281-344-4455
Practice Address - Fax:281-344-4581
Is Sole Proprietor?:No
Enumeration Date:2013-06-18
Last Update Date:2015-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12996122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist