Organization
HAEUSSNER DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THEODORE ADRIAN HAEUSSNER DMD (PRESIDENT)
(904) 264-2483
Entity
Organization
Contact information
Practice address
1409 KINGSLEY AVE, BLDG. #11, ORANGE PARK, FL 32073-4562
(904) 264-2483
(904) 264-0474
Mailing address
1409 KINGSLEY AVE, BLDG. #11, ORANGE PARK, FL 32073-4562
(904) 264-2483
(904) 264-0474
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN 6384
FL
Other
Enumeration date
03/28/2007
Last updated
08/22/2020
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