# JONATHAN HAYNIE DDS, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588104038
- **Authorized official:** DR. JONATHAN HAYNIE DDS (PRESIDENT/CEO)
- **Authorized official phone:** (619) 280-7866

## Contact information

- **Practice address:** 6616 MISSION GORGE RD, SAN DIEGO, CA 92120-2309
- **Practice address phone:** (619) 280-7866
- **Practice address fax:** (619) 280-7895
- **Mailing address:** 6616 MISSION GORGE RD, SAN DIEGO, CA 92120-2309
- **Mailing address phone:** (619) 280-7866
- **Mailing address fax:** (619) 280-7895

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 62780 | CA | Yes |

## Other

- **Enumeration date:** 03/02/2017
- **Last updated:** 03/02/2017