Provider Demographics
NPI:1184069262
Name:HAFFEY, PATRICK KYLE (DDS)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:KYLE
Last Name:HAFFEY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2323 S 171ST ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68130-4651
Mailing Address - Country:US
Mailing Address - Phone:402-933-7800
Mailing Address - Fax:402-933-7875
Practice Address - Street 1:2323 S 171ST ST
Practice Address - Street 2:SUITE 104
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68130-4651
Practice Address - Country:US
Practice Address - Phone:402-933-7800
Practice Address - Fax:402-933-7875
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-02
Last Update Date:2014-07-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE71321223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics