Provider Demographics
NPI:1245372614
Name:HAAS, CHARLES DAVID (DMD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:DAVID
Last Name:HAAS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1688 MERIDIAN AVE
Mailing Address - Street 2:SUITE 414
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-1740
Mailing Address - Country:US
Mailing Address - Phone:305-534-2526
Mailing Address - Fax:305-672-2536
Practice Address - Street 1:1688 MERIDIAN AVE
Practice Address - Street 2:SUITE 414
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33139-1740
Practice Address - Country:US
Practice Address - Phone:305-534-2526
Practice Address - Fax:305-672-2536
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5389122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist