Stacy Haddock
Dental Hygienist
690 3rd St Ste 200
Beloit
, Wisconsin 53511-6214
Stacy Haddock
Dental Hygienist
690 3rd St Ste 200
Beloit
, Wisconsin 53511-6214
(608) 299-3316
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About
Features
Specialties
- Dental Hygienist
Languages spoken
- English
Location
First Address
- Stacy Haddock
- 690 3rd St Ste 200
- Beloit, WI
- Zip : 53511-6214
- Phone : (608) 299-3316
Second Address
- Stacy Haddock
- 690 3rd St Ste 200
- Beloit, WI
- Zip : 53511-6214
- Phone : (608) 299-3316
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 124Q00000X | Dental Hygienist | 10927-16 | WI |
National Provider Identifier
| NPI | 1043637705 |
|---|---|
| Provider Name | Stacy Haddock |
| First Address | Beloit, WI 53511-6214 |
| Second Address | Beloit, WI 53511-6214 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 19/03/2014 |
| Last Update Date | 19/03/2014 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.