Jack W. Haney, D.d.s., P.c.
NPI #1124598594 in Saint Louis, Missouri
Provider Information
- NPI Number
- 1124598594
- Entity Type
- Organization
- Organization Name
- Jack W. Haney, D.d.s., P.c.
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Nov 28, 2018
- Last Updated
- Nov 28, 2018
Practice Location
- Address
- 4527 FOREST PARK AVE
- City
- Saint Louis
- State
- Missouri
- ZIP Code
- 63108-2113
- Phone
- (314) 367-7200
Authorized Official
- Name
- TY JUSTICE
- Title
- DIRECTOR, PAYER RELATIONS
- Phone
- (513) 808-4984
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist |
| Dentist - General Practice — General Practice |
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