Provider Demographics
NPI:1235278797
Name:HAIAR, DAVID A (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:A
Last Name:HAIAR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 EAST STATE STREET
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:SD
Mailing Address - Zip Code:57043-0077
Mailing Address - Country:US
Mailing Address - Phone:605-648-3511
Mailing Address - Fax:605-648-3819
Practice Address - Street 1:305 EAST STATE ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:SD
Practice Address - Zip Code:57043-0077
Practice Address - Country:US
Practice Address - Phone:605-648-3511
Practice Address - Fax:605-648-3819
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDM549122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD7803390Medicaid