Provider Demographics
NPI:1598971095
Name:HANEY, HAROLD EUGENE JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:EUGENE
Last Name:HANEY
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2156 S LAMAR BLVD
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655-5224
Mailing Address - Country:US
Mailing Address - Phone:662-234-4504
Mailing Address - Fax:662-234-4505
Practice Address - Street 1:2156 S LAMAR BLVD
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-5224
Practice Address - Country:US
Practice Address - Phone:662-234-4504
Practice Address - Fax:662-234-4505
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1929-81122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist