Provider Demographics
NPI:1285760215
Name:HAFFNER, CHRISTY LYNN (DMD)
Entity type:Individual
Prefix:DR
First Name:CHRISTY
Middle Name:LYNN
Last Name:HAFFNER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3005 ROYAL BLVD S
Mailing Address - Street 2:SUITE 120
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-1409
Mailing Address - Country:US
Mailing Address - Phone:770-777-9400
Mailing Address - Fax:770-777-0119
Practice Address - Street 1:3005 ROYAL BLVD S
Practice Address - Street 2:SUITE 120
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022-1409
Practice Address - Country:US
Practice Address - Phone:770-777-9400
Practice Address - Fax:770-777-0119
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX358971223P0221X
GA0117861223P0221X
SC36011223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA582537918OtherTIN