Provider Demographics
NPI:1487223301
Name:HASEMAN, JOHN (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:HASEMAN
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 1:327 WESTERN AVE STE A
Mailing Address - Street 2:
Mailing Address - City:FERGUS FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56537-2403
Mailing Address - Country:US
Mailing Address - Phone:218-998-2218
Mailing Address - Fax:218-333-1515
Practice Address - Street 1:327 WESTERN AVE STE A
Practice Address - Street 2:
Practice Address - City:FERGUS FALLS
Practice Address - State:MN
Practice Address - Zip Code:56537-2403
Practice Address - Country:US
Practice Address - Phone:218-998-2218
Practice Address - Fax:218-333-1515
Is Sole Proprietor?:No
Enumeration Date:2021-06-24
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND145541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice