MEDICARE: HAYNER DENTAL LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223E0200X	Endodontics
2	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1154153989
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAYNER DENTAL LLC

Provider Business Mailing Address
First Line	:	129 28TH ST
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15222-4797
Country	:	US
Telephone Number	:	412-281-3955
Fax Number	:	412-281-4880

Provider Business Practice Location Address
First Line	:	129 28TH ST
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15222-4797
Country	:	US
Telephone Number	:	412-281-3955
Fax Number	:	412-281-4880

Authorized Official
Title or Position	:	OWNER - DENTIST
Name	:	DR. CHRISTOPHER PAUL HAYNER
Credential	:	DMD
Telephone Number	:	412-281-3955

Provider Enumeration Date	:	08/19/2024
Last Update Date	:	08/19/2024

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