Individual
ANASTASIA MARIE HAUPT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
807 DAVIS ST UNIT 2011, EVANSTON, IL 60201-7104
(208) 251-6098
Mailing address
807 DAVIS ST UNIT 2011, EVANSTON, IL 60201-7104
(208) 251-6098
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
019029070
IL
Other
Enumeration date
04/20/2012
Last updated
07/21/2022
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