Provider Demographics
NPI:1588685739
Name:ALLEN N. HAIMES D.D.S.,P.A.
Entity type:Organization
Organization Name:ALLEN N. HAIMES D.D.S.,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:N
Authorized Official - Last Name:HAIMES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:727-392-2296
Mailing Address - Street 1:10710 SEMINOLE BLVD
Mailing Address - Street 2:SUITE#3
Mailing Address - City:SEMINOLE
Mailing Address - State:FL
Mailing Address - Zip Code:33778-3316
Mailing Address - Country:US
Mailing Address - Phone:727-392-2296
Mailing Address - Fax:727-397-9463
Practice Address - Street 1:10710 SEMINOLE BLVD
Practice Address - Street 2:SUITE#3
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33778-3316
Practice Address - Country:US
Practice Address - Phone:727-392-2296
Practice Address - Fax:727-397-9463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2009-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty