Charles Richard Hazen, DDS
Individual provider Active NPI Public Health Dentistry · Haines, AK
NPI 1992877385 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1992877385
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Public Health Dentistry 1223D0001X
- License
- DEN D 541 (AK)
- Practice address
- 131 1St Ave. South
Haines, AK 99827-1529 - Phone
- (907) 766-6372
- Fax
- (907) 766-2581
- NPI assigned
- Nov 14, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DEN D 541 | AK | MD | Public Health Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health Dentistry | 1223D0001X | DEN D 541 | AK | Yes |
Addresses
Primary practice location
131 1St Ave. South
Haines, AK 99827-1529
Mailing address
PO Box 1529
131 1St Ave. South
Haines, AK 99827-1529
Phone (907) 766-6372
Other providers in Haines, AK
- Claire Giordano
- Madeline Kathleen Haff
- Haines Assisted Living, Inc.
- Haines Volunteer Fire Department
- Marnie Hartman
- Shori A Heaton
- Heidi R Robichaud
- Julia I Heinz
- Margaret Michaelene Heyman-Hotch
- Shelley Ann Hodnik
All providers in Haines, AK · Public Health Dentistry in Alaska
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.