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General NPI Number Information
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NPI Number | 1538422662
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Entity Type | Individual
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Provider Name | ELLIOT HAYBARGER DMD
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Gender | Male
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Dates
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Enumeration Date | 06/22/2012
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Last Update Date | 11/13/2024
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Provider Practice Location Address
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Address Line | 233 E BLACKSTOCK RD STE D
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City | SPARTANBURG
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State | SC
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Zip | 29301-2652
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Country | US
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Telephone | 864-576-3678
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Fax | 864-576-3181
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Provider Business Mailing Address
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Address Line | 233 E BLACKSTOCK RD STE D
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City | SPARTANBURG
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State | SC
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Zip | 29301-2652
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Country | US
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Telephone | 724-971-2825
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Fax | 864-576-3181
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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 | DS039125
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 1223D0004X
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Taxonomy Name | Dental Anesthesiology
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License Number | 8587
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 8587
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License Number State | SC
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