Provider Demographics
NPI:1750448312
Name:HAASLO, ZARA (DDS , MSC)
Entity Type:Individual
Prefix:DR
First Name:ZARA
Middle Name:
Last Name:HAASLO
Suffix:
Gender:F
Credentials:DDS , MSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 80220
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85060-0220
Mailing Address - Country:US
Mailing Address - Phone:602-626-5437
Mailing Address - Fax:602-956-5428
Practice Address - Street 1:3722 E THOMAS RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-7508
Practice Address - Country:US
Practice Address - Phone:602-626-5437
Practice Address - Fax:602-956-5428
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD58301223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics