Provider Demographics
NPI:1447312830
Name:HASKINS, DANIEL F (DDS)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:F
Last Name:HASKINS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10022 SOUTH KEDZIE AVE
Mailing Address - Street 2:
Mailing Address - City:EVERGREEN PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60805-3420
Mailing Address - Country:US
Mailing Address - Phone:708-229-0444
Mailing Address - Fax:708-229-0073
Practice Address - Street 1:10022 SOUTH KEDZIE AVE
Practice Address - Street 2:
Practice Address - City:EVERGREEN PARK
Practice Address - State:IL
Practice Address - Zip Code:60805-3420
Practice Address - Country:US
Practice Address - Phone:708-229-0444
Practice Address - Fax:708-229-0073
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL15490122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist