| Gordon E Haag, Jr, Dds, Inc | |
|
301 W Bastanchury Rd Suite 260 Fullerton CA 92835-3419 | |
| (714) 879-4910 | |
| (714) 879-5563 |
| Full Name | Gordon E Haag, Jr, Dds, Inc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 301 W Bastanchury Rd, Fullerton, California |
| Authorized Official Name and Position | Gordon E Haag (OWNER) |
| Authorized Official Contact | 7148794910 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gordon E Haag, Jr, Dds, Inc 301 W Bastanchury Rd Suite 260 Fullerton CA 92835-3419 Ph: (714) 879-4910 | Gordon E Haag, Jr, Dds, Inc 301 W Bastanchury Rd Suite 260 Fullerton CA 92835-3419 Ph: (714) 879-4910 |
| NPI Number | 1457621260 |
|---|---|
| Provider Enumeration Date | 01/10/2012 |
| Last Update Date | 01/10/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457621260 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 272952 (California) | Primary |
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