Timothy Paul Haas, D.D.S.
Individual provider Active NPI General Practice Dentistry · Peru, IL
NPI 1124177720 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1124177720
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- Practice address
- 2011 Rock St
Suite, B
Peru, IL 61354-1385 - Phone
- (815) 223-0149
- Fax
- (815) 223-3199
- NPI assigned
- Jan 10, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | IL | Yes |
Addresses
Primary practice location
2011 Rock St
Suite, B
Peru, IL 61354-1385
Mailing address
2011 Rock St
Suite, B
Peru, IL 61354-1385
Phone (815) 223-0149
Other providers in Peru, IL
- Ram Goel
- Eryn Analise Goetze
- Michael John Grabowski
- Breann Michele Gray
- Bradley Groleau
- Hanger Prosthetics & Orthotics, Inc
- Krystal C Hanson
- Diane Marie Harrod
- Health and Safety International, Inc
- Mark Alan Henry
All providers in Peru, IL · General Practice Dentistry in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.