Provider Demographics
NPI:1841337748
Name:HAAS, TERRY ALVIN (DDS)
Entity type:Individual
Prefix:DR
First Name:TERRY
Middle Name:ALVIN
Last Name:HAAS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 N ROCK SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-2340
Mailing Address - Country:US
Mailing Address - Phone:919-426-6154
Mailing Address - Fax:919-575-2682
Practice Address - Street 1:JOHN UMSTEAD HOSPITAL
Practice Address - Street 2:1003 WEST 12TH STREET
Practice Address - City:BUTNER
Practice Address - State:NC
Practice Address - Zip Code:27509
Practice Address - Country:US
Practice Address - Phone:919-575-7392
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC52961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice