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DR. HAVEN RICHARD DOANE DDS

>> Dentist >> Dental Providers

Registrant NPI Number: 1265436703

Individual Registrant:
DR. HAVEN RICHARD DOANE DDS
Gender: M

Location and contact information for practice:
18670 CARTER ST M.A.C.T. HEALTH BOARD INC. INDIAN DENTAL CLINIC TUOLUMNE, CA 95379-9637 US
Tel: 209-928-4279  Fax: 209-928-4101

Contact information for business:
PO BOX 1089  TUOLUMNE, CA 95379-1089 US
Tel: 209-928-4279  Fax: 209-928-4101

Registration Information:
NPI: 1265436703
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y122300000XDental Providers
Dentist
CA13959
N122300000XDental Providers
Dentist
MI2901007202

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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