Provider Demographics
NPI:1710997598
Name:HAYNES, HANNA (DMD)
Entity Type:Individual
Prefix:MRS
First Name:HANNA
Middle Name:
Last Name:HAYNES
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 STATION AVE
Mailing Address - Street 2:
Mailing Address - City:HADDON HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:08035-1628
Mailing Address - Country:US
Mailing Address - Phone:856-547-5112
Mailing Address - Fax:856-547-5112
Practice Address - Street 1:801 STATION AVE
Practice Address - Street 2:
Practice Address - City:HADDON HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:08035
Practice Address - Country:US
Practice Address - Phone:856-547-5112
Practice Address - Fax:856-310-9097
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2015-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI202101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice