Provider Demographics
NPI:1467538561
Name:HAINES, PAUL G II (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:G
Last Name:HAINES
Suffix:II
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:PO BOX 887
Mailing Address - Street 2:
Mailing Address - City:VINITA
Mailing Address - State:OK
Mailing Address - Zip Code:74301-0887
Mailing Address - Country:US
Mailing Address - Phone:918-256-3392
Mailing Address - Fax:918-256-4421
Practice Address - Street 1:442606 EAST 250 RD.
Practice Address - Street 2:
Practice Address - City:VINITA
Practice Address - State:OK
Practice Address - Zip Code:74301-0887
Practice Address - Country:US
Practice Address - Phone:918-256-3392
Practice Address - Fax:918-256-4421
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2009-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5520122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist