Individual
DR. JAMES EDWARD HAACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS MS
Contact information
Practice address
515 N MAIN ST, RICE LAKE, WI 54868-1722
(715) 234-9071
Mailing address
515 N MAIN ST, RICE LAKE, WI 54868-1722
(715) 234-9071
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
5298-015
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
075-3075055
EIN
WI
Enumeration date
03/30/2007
Last updated
07/08/2007
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