Clarence Brent Haeberle in Augusta - Prosthodontics
Clarence Brent Haeberle - NPI 1912072174
Clarence Brent Haeberle is a Prosthodontics in Augusta, Georgia. Clarence Brent Haeberle practices all healthcare services and medical treatments related to Prosthodontics. The NPI Number for Clarence Brent Haeberle is 1912072174. The last update date is 2023-04-13.
Clarence Brent Haeberle's current location address is 1430 John Wesley Gilbert Dr Gc 4204, Augusta, Georgia. You can contact this provider via phone number 7067212696 and fax number 7067216778. The mailing address for Clarence Brent Haeberle is 1430 John Wesley Gilbert Dr Gc 4204, Augusta, Georgia. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Clarence Brent Haeberle |
|---|---|
| Address | 1430 John Wesley Gilbert Dr Gc 4204, Augusta, Georgia |
| Phone Number | 7067212696 |
| Fax Number | 7067216778 |
| Sole Proprietor | N |
| Credentials | DMD |
NPI Number Detail
| NPI Number | 1912072174 |
|---|---|
| Provider Enumeration Date | 2006-11-22 |
| Last Updated Date | 2023-04-13 |
Provider Mailing Address Detail
| Address | 1430 John Wesley Gilbert Dr Gc 4204 |
|---|---|
| City | Augusta |
| State | Georgia (GA) |
| Post Code | 309120004 |
| Phone Number | 7067212696 |
| Fax Number | 7067216778 |
Provider's Primary Taxonomy Detail
| Speciality | Prosthodontics |
|---|---|
| Taxonomy | 1223P0700X |
| Licence No | DNF000362 |
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Definition: That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 003116961B | GA | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Clarence Brent Haeberle by the Centers for Medicare & Medicaid Services?
The Clarence Brent Haeberle has been assigned the NPI (National Provider Identifier) 1912072174. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Clarence Brent Haeberle's physical address?
The Clarence Brent Haeberle is physically located at 1430 John Wesley Gilbert Dr Gc 4204, in the city of Augusta, GA, with the postal code 309120004.
What is the Clarence Brent Haeberle's area of specialization and corresponding taxonomy classification?
The Clarence Brent Haeberle's specialty field is Prosthodontics, and it falls under the taxonomy code 1223P0700X, which categorizes healthcare providers based on their specialties.
On what date did the Clarence Brent Haeberle receive the assignment of its 1912072174 from the Centers for Medicare & Medicaid Services?
The Clarence Brent Haeberle was issued its 1912072174 by the Centers for Medicare & Medicaid Services on 2006-11-22.
When was the Clarence Brent Haeberle's information last updated?
The Clarence Brent Haeberle's information was last updated on 2023-04-13.