1962690081 NPI number — R. TODD HAFT, D.D.S.,P.C.

Table of content: ELLEN MARIE JANSYN MD (NPI 1417902008)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962690081 NPI number — R. TODD HAFT, D.D.S.,P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
R. TODD HAFT, D.D.S.,P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1962690081
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/15/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
16215 N ORACLE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TUCSON
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85739-4292
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
520-825-2195
Provider Business Mailing Address Fax Number:
520-825-7143

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
16215 N ORACLE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TUCSON
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85739-4292
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
520-825-2195
Provider Business Practice Location Address Fax Number:
520-825-7143
Provider Enumeration Date:
10/15/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HAFT
Authorized Official First Name:
R
Authorized Official Middle Name:
TODD
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
520-825-2195

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  4378 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)