Provider Demographics
NPI:1871307959
Name:HEATHROW DENTAL LLC
Entity type:Organization
Organization Name:HEATHROW DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALARCON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-936-4867
Mailing Address - Street 1:120 INTERNATIONAL PKWY STE 264
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-5033
Mailing Address - Country:US
Mailing Address - Phone:407-333-2113
Mailing Address - Fax:
Practice Address - Street 1:120 INTERNATIONAL PKWY STE 264
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-5033
Practice Address - Country:US
Practice Address - Phone:407-333-2113
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-06
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental