Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 7156 | CO |
NPI | 1063598720 |
---|---|
Provider Name | Mrs. Michelle Lee Haman |
First Address | Colorado Springs, CO 80918-7300 |
Second Address | Colorado Springs, CO 80918-7300 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2006 |
Last Update Date | 08/07/2007 |