Provider Demographics
NPI:1992465207
Name:JACQUELINE HAKER-BONCI DDS PLLC
Entity type:Organization
Organization Name:JACQUELINE HAKER-BONCI DDS PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:HAKER-BONCI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-367-3102
Mailing Address - Street 1:8 LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-3219
Mailing Address - Country:US
Mailing Address - Phone:781-367-3102
Mailing Address - Fax:
Practice Address - Street 1:11 HAMPTON RD
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:NH
Practice Address - Zip Code:03833-4807
Practice Address - Country:US
Practice Address - Phone:603-988-0229
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-28
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty