Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 30017901 | OH |
NPI | 1073595500 |
---|---|
Provider Name | Dr. Mark Francis Haas |
First Address | Cuyahoga Falls, OH 44223-2104 |
Second Address | Cuyahoga Falls, OH 44223-2104 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2005 |
Last Update Date | 13/12/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0959600 | (05) | OH |