Provider Demographics
NPI:1376940296
Name:KAITLIN HAAG DDS PC
Entity type:Organization
Organization Name:KAITLIN HAAG DDS PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KAITLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAAG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-350-2778
Mailing Address - Street 1:2009 W J ST
Mailing Address - Street 2:
Mailing Address - City:MC COOK
Mailing Address - State:NE
Mailing Address - Zip Code:69001-3090
Mailing Address - Country:US
Mailing Address - Phone:308-345-2273
Mailing Address - Fax:308-345-2750
Practice Address - Street 1:2009 W J ST
Practice Address - Street 2:
Practice Address - City:MC COOK
Practice Address - State:NE
Practice Address - Zip Code:69001-3090
Practice Address - Country:US
Practice Address - Phone:308-345-2273
Practice Address - Fax:308-345-2750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-20
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Multi-Specialty