Individual
DR. GRIFFITH ALLEN HAEGGQUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4212 N 16TH ST, PHOENIX, AZ 85016-5319
(602) 263-1200
(602) 200-5383
Mailing address
PO BOX 31001-0698, PASADENA, CA 91110-0698
(602) 263-1200
(602) 200-5383
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
D5062
AZ
1223P0221X
Pediatric Dentistry
Primary
D5062
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
476699
—
AZ
Enumeration date
03/28/2006
Last updated
11/13/2017
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