Individual
DR. SUSAN M HAYNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2065 AIRWAY AVE, SUITE B, KINGMAN, AZ 86409-3656
(928) 692-1100
Mailing address
3215 ISADOR AVE, KINGMAN, AZ 86401-6471
(928) 279-9623
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7531
AZ
Other
Enumeration date
08/04/2008
Last updated
11/29/2010
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