Haeggquist, Griffith Allen

Haeggquist, Griffith Allen is an individual health care provider with primary practice located at 4212 N 16Th St , Phoenix AZ 85016-5319. He recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Dental Providers / Pediatric Dentistry. Dental Providers / Pediatric Dentistry is his primary health care specialty. Haeggquist, Griffith Allen can be contacted via phone (602) 263-1200.

Contact Information

Primary practice address
4212 N 16Th St Phoenix AZ 85016-5319
Phone: (602) 263-1200
Fax: (602) 200-5383
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X D5062 Arizona
Dental Providers / Pediatric Dentistry 1223P0221X D5062 Arizona

Profile Details

NPI number 1760443105
LBN Legal business name Haeggquist, Griffith Allen
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 28th, 2006
Last updated Nov 13th, 2017 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760443105 NPPES
Arizona MEDICAID 476699

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