NPI 1154540854 · live from the CMS NPI Registry
Wade Larry Haslam, D.M.D.
Dentist, Orthodontics and Dentofacial Orthopedics in Corvallis, OR. National Provider Identifier 1154540854, active.
NPI record
| NPI | 1154540854 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dentist, Orthodontics and Dentofacial Orthopedics 1223X0400X |
| Practice location | 2657 Nw Rolling Green Dr, Corvallis, OR 97330 |
| Practice phone | 541-757-2440 |
| Enumerated | April 24, 2007 |
| Last updated | July 8, 2007 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist, Orthodontics and Dentofacial Orthopedics primary | 1223X0400X | D6961 (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.