Individual
GLEN HAISLEY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5540 JOHNSTON ST, LAFAYETTE, LA 70503-5138
(337) 247-7698
Mailing address
7340 BRIARHEATH DR, NEW ORLEANS, LA 70128-2412
(504) 994-3036
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7689
LA
Other
Enumeration date
05/17/2025
Last updated
05/17/2025
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