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General NPI Number Information
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NPI Number | 1346300175
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Entity Type | Individual
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Provider Name | GERALD D HAUSE DDS
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Gender | Male
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1101 ONE AND A HALF S WASHINGTON
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City | LANSING
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State | MI
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Zip | 48910
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Country | US
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Telephone | 517-482-6019
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Fax |
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Provider Business Mailing Address
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Address Line | 6220 E GOLFRIDGE DR
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City | EAST LANSING
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State | MI
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Zip | 48823
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Country | US
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Telephone | 517-322-6403
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Fax | 517-332-6401
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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 | 8475
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License Number State | MI
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