Provider Demographics
NPI:1174269955
Name:HAUG, ALEXANDER (ARMY X2)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:
Last Name:HAUG
Suffix:
Gender:M
Credentials:ARMY X2
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2901 CASSIDY RD
Mailing Address - Street 2:
Mailing Address - City:FORT BLISS
Mailing Address - State:TX
Mailing Address - Zip Code:79916-3502
Mailing Address - Country:US
Mailing Address - Phone:915-742-6001
Mailing Address - Fax:
Practice Address - Street 1:1363 ABERDEEN AVENUE
Practice Address - Street 2:
Practice Address - City:WHITE SANDS MISSILE RANGE
Practice Address - State:NM
Practice Address - Zip Code:88002
Practice Address - Country:US
Practice Address - Phone:575-678-3597
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-05
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist