Individual
MR. ROBERT CHARLES HAACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
6809 CASCADE RD SE STE F, SUITE E, GRAND RAPIDS, MI 49546-6895
(616) 942-9040
(616) 837-9705
Mailing address
6809 CASCADE RD SE STE F, SUITE E, GRAND RAPIDS, MI 49546-6895
(616) 942-9040
(616) 837-9705
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901010428
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D104280
BLUE CROSS / BLUE SHIELD
—
Enumeration date
01/16/2006
Last updated
08/23/2016
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