Haines, Lisa D.

Haines, Lisa D. is an individual health care provider with primary practice located at 11001 Manchester Rd , Kirkwood MO 63122-1243. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Haines, Lisa D. can be contacted via phone (314) 966-7778.

Contact Information

Primary practice address
11001 Manchester Rd Kirkwood MO 63122-1243
Phone: (314) 966-7778
Fax: (314) 909-1579
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 2003016572 Missouri

Profile Details

NPI number 1114136058
LBN Legal business name Haines, Lisa D.
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 21st, 2007
Last updated Jul 8th, 2007 - about 19 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 1114136058 NPPES
Missouri Other 20-1467596 TAX ID

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