Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223P0106X | Oral and Maxillofacial Pathology | DN16141 | FL |
Y | 1223P0221X | Pediatric Dentist | 44 | SC |
N | 1223P0221X | Pediatric Dentist | DN16141 | FL |
NPI | 1396904405 |
---|---|
Provider Name | Christel Maria Haberland |
First Address | Charleston, SC 29425-8908 |
Second Address | Charleston, SC 29425-4804 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2008 |
Last Update Date | 23/10/2020 |