Provider Demographics
NPI:1578586699
Name:HAIMES, ALLEN N (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:N
Last Name:HAIMES
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 1:10710 SEMINOLE BLVD
Mailing Address - Street 2:SUITE#3
Mailing Address - City:SEMINOLE
Mailing Address - State:FL
Mailing Address - Zip Code:33778-3316
Mailing Address - Country:US
Mailing Address - Phone:727-392-2296
Mailing Address - Fax:727-397-9463
Practice Address - Street 1:10710 SEMINOLE BLVD
Practice Address - Street 2:SUITE#3
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33778-3316
Practice Address - Country:US
Practice Address - Phone:727-392-2296
Practice Address - Fax:727-397-9463
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL71731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice