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HAAKE FAMILY DENTAL LLC

Endodontics

Overland Park, Kansas

Provider NPI: 1275703811

Organization Information:
Organization Name:  HAAKE FAMILY DENTAL LLC
Organization is not Subpart
Authorized Official:  STEPHEN M HAAKE  DENTIST  913-3816644

Practice Location:
4601 W 109TH ST SUITE 112 OVERLAND PARK, KS 66211 US
Tel: 913-381-6644  Fax: 913-381-6646

Business Mailing Address:
4601 W 109TH ST SUITE 112 OVERLAND PARK, KS 66211 US
Tel: 913-381-6644  Fax: 913-381-6646

Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1223E0200XDental Providers
Dentist
Endodontics
KS60089





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