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General NPI Number Information
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NPI Number | 1033696943
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Entity Type | Individual
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Provider Name | ABBY R HAILAND DDS
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Gender | Female
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Dates
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Enumeration Date | 07/24/2018
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Last Update Date | 12/16/2021
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Provider Practice Location Address
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Address Line | 610 N GEYER RD
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City | KIRKWOOD
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State | MO
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Zip | 63122-2756
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Country | US
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Telephone | 314-965-4064
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Fax | 314-965-1141
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Provider Business Mailing Address
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Address Line | 5539 PERSHING AVE APT 511
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City | SAINT LOUIS
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State | MO
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Zip | 63112-2136
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Country | US
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Telephone | 913-972-4077
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 2018017815
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License Number State | MO
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