Provider Demographics
NPI:1689910473
Name:HAAS, SHARON ELISA (DDS)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:ELISA
Last Name:HAAS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2424 S DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-7916
Mailing Address - Country:US
Mailing Address - Phone:561-659-7660
Mailing Address - Fax:561-659-7125
Practice Address - Street 1:2424 S DIXIE HWY
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-7916
Practice Address - Country:US
Practice Address - Phone:561-659-7660
Practice Address - Fax:561-659-7125
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-24
Last Update Date:2012-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN127021223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics