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Individual

DR. ERIC HAYNAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S

Contact information

Practice address
401 CECIL G COSTIN SR BLVD, PORT ST JOE, FL 32456-1928
(850) 229-1043
Mailing address
2475 GARRISON AVE, PORT ST JOE, FL 32456-5265
(850) 229-1043

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
63516
CA
1223G0001X
General Practice Dentistry
Primary
DN25097
FL

Other

Enumeration date
09/10/2015
Last updated
05/01/2023
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