Organization
GORDON E HAAG, JR, DDS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GORDON E HAAG JR. DDS (OWNER)
(714) 879-4910
Entity
Organization
Contact information
Practice address
301 W BASTANCHURY RD, SUITE 260, FULLERTON, CA 92835-3419
(714) 879-4910
(714) 879-5563
Mailing address
301 W BASTANCHURY RD, SUITE 260, FULLERTON, CA 92835-3419
(714) 879-4910
(714) 879-5563
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
272952
CA
Other
Enumeration date
01/10/2012
Last updated
01/10/2012
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