Individual
DR. JEFFREY ROBERT HASLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS FAGD PC
Contact information
Practice address
5300 S ADAMS AVENUE PARKWAY, SUITE #4, OGDEN, UT 84405-6966
(801) 479-1700
(801) 476-8305
Mailing address
5300 S ADAMS AVENUE PARKWAY, SUITE #4, OGDEN, UT 84405-6966
(801) 479-1700
(801) 476-8305
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
144146
UT
Other
Enumeration date
08/04/2006
Last updated
07/08/2007
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