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General NPI Number Information
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NPI Number | 1861579765
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Entity Type | Individual
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Provider Name | HAROLD J HANEY DMD
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Gender | Male
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 432 ROLLING RIDGE DR SUITE 2
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City | STATE COLLEGE
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State | PA
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Zip | 16801-7640
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Country | US
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Telephone | 814-234-0921
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Fax | 814-234-6240
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Provider Business Mailing Address
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Address Line | 134 OVERFIELD CIR
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City | PORT MATILDA
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State | PA
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Zip | 16870-7105
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Country | US
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Telephone | 814-234-9083
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Fax |
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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 | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | DS024017L
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License Number State | PA
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