Individual
MRS. AUTUMN JEAN HALEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DENTAL ASSISTANT
Contact information
Practice address
150 AMBERWOOD DR, FORT STEWART, GA 31315-1780
(970) 310-4629
Mailing address
150 AMBERWOOD DR, FORT STEWART, GA 31315-1780
(970) 310-4629
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
—
Other
Enumeration date
06/12/2013
Last updated
06/12/2013
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