Provider Demographics
NPI:1982628467
Name:HAIGLER, MARY CHARLES (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:CHARLES
Last Name:HAIGLER
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:PO BOX 49187
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29649-0004
Mailing Address - Country:US
Mailing Address - Phone:864-229-3310
Mailing Address - Fax:864-229-5075
Practice Address - Street 1:280 ROCKY SLOPE RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-3908
Practice Address - Country:US
Practice Address - Phone:864-751-9972
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC41931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No1223G0001XDental ProvidersDentistGeneral Practice