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General NPI Number Information
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NPI Number | 1326279498
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Entity Type | Organization
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Legal Business Name | AMANDA EWING HASZINGER, DDS
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Dates
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Enumeration Date | 08/06/2009
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Last Update Date | 08/06/2009
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Provider Practice Location Address
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Address Line | 3645 WILLIAMS BLVD STE 103
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City | KENNER
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State | LA
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Zip | 70065-3464
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Country | US
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Telephone | 504-443-5882
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Fax | 504-324-0952
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Provider Business Mailing Address
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Address Line | 3645 WILLIAMS BLVD STE 103
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City | KENNER
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State | LA
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Zip | 70065-3464
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Country | US
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Telephone | 504-443-5882
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Fax | 504-324-0952
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Authorized Official
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Title or Position | OWNER
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Name | DR. AMANDA EWING HASZINGER
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Credential | DDS
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Telephone | 504-443-5882
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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 | 5802
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 5799
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License Number State | LA
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