Provider Demographics
NPI:1710214812
Name:HAUSER, THOMAS E (LD, DPD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:E
Last Name:HAUSER
Suffix:
Gender:M
Credentials:LD, DPD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1268 E MAIN ST
Mailing Address - Street 2:SUITE 5
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98002-5748
Mailing Address - Country:US
Mailing Address - Phone:253-833-1834
Mailing Address - Fax:253-833-1841
Practice Address - Street 1:1268 E MAIN ST
Practice Address - Street 2:SUITE 5
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-5748
Practice Address - Country:US
Practice Address - Phone:253-833-1834
Practice Address - Fax:253-833-1841
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-10
Last Update Date:2009-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADN 60051783122400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122400000XDental ProvidersDenturist