Provider Demographics
NPI:1881757789
Name:HAFNER, THOMAS H (DMD LLC)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:H
Last Name:HAFNER
Suffix:
Gender:M
Credentials:DMD LLC
Other - Prefix:DR
Other - First Name:THOMAS
Other - Middle Name:H
Other - Last Name:HAFNER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:415 W SADDLE RIVER ROAD
Mailing Address - Street 2:
Mailing Address - City:UPPER SADDLE RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07458
Mailing Address - Country:US
Mailing Address - Phone:201-327-7757
Mailing Address - Fax:201-327-7757
Practice Address - Street 1:415 W SADDLE RIVER ROAD
Practice Address - Street 2:
Practice Address - City:UPPER SADDLE RIVER
Practice Address - State:NJ
Practice Address - Zip Code:07458
Practice Address - Country:US
Practice Address - Phone:201-327-7757
Practice Address - Fax:201-327-7757
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI017097001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice