Provider Demographics
NPI:1780722041
Name:BORNEMANN, HEATHER (RDH)
Entity type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:
Last Name:BORNEMANN
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4260 US HIGHWAY 9
Mailing Address - Street 2:HOWELL PROFESSIONAL CENTER
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731-3351
Mailing Address - Country:US
Mailing Address - Phone:732-363-5115
Mailing Address - Fax:732-370-9392
Practice Address - Street 1:4260 US HIGHWAY 9
Practice Address - Street 2:HOWELL PROFESSIONAL CENTER
Practice Address - City:HOWELL
Practice Address - State:NJ
Practice Address - Zip Code:07731-3351
Practice Address - Country:US
Practice Address - Phone:732-363-5115
Practice Address - Fax:732-370-9392
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22H1008287000124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist