Provider Demographics
NPI:1013179068
Name:HAWK, HALEY ANN (DMD)
Entity Type:Individual
Prefix:DR
First Name:HALEY
Middle Name:ANN
Last Name:HAWK
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2217 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16602-2243
Mailing Address - Country:US
Mailing Address - Phone:814-935-8099
Mailing Address - Fax:814-941-6134
Practice Address - Street 1:1500 4TH AVE
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16602-3616
Practice Address - Country:US
Practice Address - Phone:814-946-8929
Practice Address - Fax:814-941-6134
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-01
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS037505122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist