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:
Health care specialties
Specialty | Code | License # | 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 7 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1760443105 | NPPES |
Arizona | MEDICAID | 476699 |
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