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General NPI Number Information
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NPI Number | 1992929202
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Entity Type | Organization
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Legal Business Name | HAERR DENTISTRY P.C.
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 150 WEST JACKSON ST
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City | HAYDEN
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State | CO
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Zip | 81639
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Country | US
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Telephone | 970-276-3123
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Fax | 970-276-2500
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Provider Business Mailing Address
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Address Line | PO BOX 609
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City | HAYDEN
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State | CO
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Zip | 81639-0609
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Country | US
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Telephone | 970-276-3123
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Fax | 970-276-2500
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Authorized Official
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Title or Position | OWNER DENTIST
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Name | DR. NATHAN ADAM HAERR
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Credential | DDS
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Telephone | 970-276-3123
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 8801
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License Number State | CO
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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 | 8443
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License Number State | CO
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