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NPI Code Detail

MEDICARE: MR. DEAN M HAUSEMAN D.M.D

MEDICARE: MR. DEAN M HAUSEMAN D.M.D
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
11223E0200XEndodonticsD3048AZ

General Provider Information

NPI Number : 1922151539
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DEAN M HAUSEMAN D.M.D
Provider Business Mailing Address
First Line : 1011 N CRAYCROFT RD
Second Line : SUITE 107
City : TUCSON
State : AZ
Zip : 85711-7309
Country : US
Telephone Number : 520-322-0800
Fax Number : 520-917-2358
Provider Business Practice Location Address
First Line : 1011 N CRAYCROFT RD
Second Line : SUITE 107
City : TUCSON
State : AZ
Zip : 85711-7309
Country : US
Telephone Number : 520-322-0800
Fax Number : 520-917-2358
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2007
Last Update Date : 07/08/2007

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