Provider Demographics
NPI:1053478032
Name:HAFFNER, DEBORAH ELIZABETH (DMD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:ELIZABETH
Last Name:HAFFNER
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 1:402 OLD TROLLEY RD
Mailing Address - Street 2:SUITE 109
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29485-5608
Mailing Address - Country:US
Mailing Address - Phone:843-821-2500
Mailing Address - Fax:
Practice Address - Street 1:402 OLD TROLLEY RD
Practice Address - Street 2:SUITE 109
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29485-5608
Practice Address - Country:US
Practice Address - Phone:843-821-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC36041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice