Individual
DR. LISA JAN HADDOX-HESTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
1 WILDCAT WAY, LOGAN, WV 25601-3474
(304) 688-9949
(304) 688-9953
Mailing address
7400 LYNN AVE, HAMLIN, WV 25523-1138
(304) 824-5806
(304) 824-5804
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2962
WV
Other
Enumeration date
07/10/2008
Last updated
04/28/2015
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