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General NPI Number Information
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NPI Number | 1295165090
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Entity Type | Organization
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Legal Business Name | JAMES B. HAAS, DDS PA
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Dates
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Enumeration Date | 11/15/2013
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Last Update Date | 11/15/2013
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Provider Practice Location Address
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Address Line | 4 MANCHESTER AVE
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City | DERRY
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State | NH
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Zip | 03038-1931
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Country | US
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Telephone | 603-434-1586
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Fax | 603-434-8025
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Provider Business Mailing Address
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Address Line | 4 MANCHESTER AVE
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City | DERRY
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State | NH
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Zip | 03038-1931
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Country | US
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Telephone | 603-434-1586
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Fax | 603-434-8025
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Authorized Official
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Title or Position | DOCTOR OF DENTAL SURGERY
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Name | DR. JAMES BRADLEY HAAS
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Credential | DDS
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Telephone | 603-434-1586
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 03954
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 2662
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License Number State | NH
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