Individual
DR. JERRY L HANEY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
404 N 4TH ST, ODESSA, MO 64076-1152
(816) 633-5393
(816) 633-5395
Mailing address
404 N 4TH ST, ODESSA, MO 64076-1152
(816) 633-5393
(816) 633-5395
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
13680
MO
Other
Enumeration date
10/04/2005
Last updated
07/08/2007
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