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General NPI Number Information
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NPI Number | 1801053962
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Entity Type | Organization
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Legal Business Name | TERRY F. HASKIN, D.D.S., INC.
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Dates
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Enumeration Date | 05/16/2008
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Last Update Date | 11/19/2014
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Provider Practice Location Address
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Address Line | 256 GREEN VALLEY RD
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City | FREEDOM
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State | CA
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Zip | 95019-3139
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Country | US
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Telephone | 831-722-4666
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Fax | 831-722-4673
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Provider Business Mailing Address
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Address Line | 256 GREEN VALLEY RD
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City | FREEDOM
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State | CA
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Zip | 95019-3139
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Country | US
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Telephone | 831-722-4666
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Fax | 831-722-4673
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TERRY F HASKIN
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Credential | DDS
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Telephone | 831-722-4666
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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 | 23441
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License Number State | CA
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