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General NPI Number Information
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NPI Number | 1245642800
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Entity Type | Organization
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Legal Business Name | DAVID E. HABECKER DDS
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Dates
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Enumeration Date | 05/29/2014
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Last Update Date | 05/29/2014
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Provider Practice Location Address
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Address Line | 529 N GRAND ST
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City | SCHOOLCRAFT
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State | MI
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Zip | 49087-9128
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Country | US
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Telephone | 269-679-5584
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Fax | 269-679-5028
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Provider Business Mailing Address
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Address Line | 529 N GRAND ST P.O. BOX 716
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City | SCHOOLCRAFT
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State | MI
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Zip | 49087-9128
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Country | US
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Telephone | 269-679-5584
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Fax | 269-679-5028
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAVID EARL HABECKER
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Credential | DDS
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Telephone | 269-679-5584
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 2901021218
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License Number State | MI
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