Haeussner Dental Group
NPI #1174642375 in Orange Park, Florida
Provider Information
- NPI Number
- 1174642375
- Entity Type
- Organization
- Organization Name
- Haeussner Dental Group
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Mar 28, 2007
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 1409 KINGSLEY AVE
- Address 2
- BLDG. #11
- City
- Orange Park
- State
- Florida
- ZIP Code
- 32073-4562
- Phone
- (904) 264-2483
Authorized Official
- Name
- DR. THEODORE ADRIAN HAEUSSNER, DMD
- Title
- PRESIDENT
- Phone
- (904) 264-2483
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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