Provider Demographics
NPI:1861729477
Name:MCCAULEY, HEATHER MICHELE (RDH)
Entity type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:MICHELE
Last Name:MCCAULEY
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 1:124 SUNFLOWER DR
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CO
Mailing Address - Zip Code:80550-5504
Mailing Address - Country:US
Mailing Address - Phone:970-460-0328
Mailing Address - Fax:
Practice Address - Street 1:124 SUNFLOWER DR
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CO
Practice Address - Zip Code:80550-5504
Practice Address - Country:US
Practice Address - Phone:970-460-0328
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-03
Last Update Date:2009-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO905328124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist