Provider Demographics
NPI:1639190325
Name:MILLS, HASKELL THOMAS II (DDS)
Entity Type:Individual
Prefix:DR
First Name:HASKELL
Middle Name:THOMAS
Last Name:MILLS
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 1:144 FLEMING AVE
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:NC
Mailing Address - Zip Code:28752-3889
Mailing Address - Country:US
Mailing Address - Phone:828-659-9444
Mailing Address - Fax:828-659-1095
Practice Address - Street 1:144 FLEMING AVE
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:NC
Practice Address - Zip Code:28752-3889
Practice Address - Country:US
Practice Address - Phone:828-659-9444
Practice Address - Fax:828-659-1095
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC63641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice