Provider Demographics
NPI:1558712166
Name:HAUGHEY, COREY (DDS)
Entity Type:Individual
Prefix:DR
First Name:COREY
Middle Name:
Last Name:HAUGHEY
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 1:1804 OLD GREENSBORO RD
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-1896
Mailing Address - Country:US
Mailing Address - Phone:901-461-7107
Mailing Address - Fax:
Practice Address - Street 1:1804 OLD GREENSBORO RD
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-1896
Practice Address - Country:US
Practice Address - Phone:901-461-7107
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-24
Last Update Date:2016-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR4125122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist