Provider Demographics
NPI:1770223018
Name:HAEMIG FAMILY DENTISTRY, PC
Entity Type:Organization
Organization Name:HAEMIG FAMILY DENTISTRY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KARL
Authorized Official - Middle Name:
Authorized Official - Last Name:HAEMIG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:651-318-7297
Mailing Address - Street 1:101 MAIN ST S STE 111
Mailing Address - Street 2:
Mailing Address - City:LE SUEUR
Mailing Address - State:MN
Mailing Address - Zip Code:56058-7503
Mailing Address - Country:US
Mailing Address - Phone:507-593-0143
Mailing Address - Fax:507-540-1402
Practice Address - Street 1:101 MAIN ST S STE 111
Practice Address - Street 2:
Practice Address - City:LE SUEUR
Practice Address - State:MN
Practice Address - Zip Code:56058-7503
Practice Address - Country:US
Practice Address - Phone:507-593-0143
Practice Address - Fax:507-540-1402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-01
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental