Provider Demographics
NPI:1982882585
Name:HAEBERER, ALFRED FRANZ III (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALFRED
Middle Name:FRANZ
Last Name:HAEBERER
Suffix:III
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21145 WHITFIELD PLACE
Mailing Address - Street 2:UNIT 102
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20165
Mailing Address - Country:US
Mailing Address - Phone:703-433-2155
Mailing Address - Fax:703-433-2152
Practice Address - Street 1:21145 WHITFIELD PLACE
Practice Address - Street 2:UNIT 102
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20165
Practice Address - Country:US
Practice Address - Phone:703-433-2155
Practice Address - Fax:703-433-2152
Is Sole Proprietor?:No
Enumeration Date:2008-02-06
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA040100681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice