Provider Demographics
NPI:1891825303
Name:HAINER, DONALD C (DDS)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:C
Last Name:HAINER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10725 SE 256TH ST
Mailing Address - Street 2:SUITE #1
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98030-8285
Mailing Address - Country:US
Mailing Address - Phone:253-854-2714
Mailing Address - Fax:253-854-3184
Practice Address - Street 1:10725 SE 256TH ST
Practice Address - Street 2:SUITE #1
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98030-8285
Practice Address - Country:US
Practice Address - Phone:253-854-2714
Practice Address - Fax:253-854-3184
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00006163122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist