Provider Demographics
NPI:1447543665
Name:HAFFORD, JOSHUA OSTEEL (DDS)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:OSTEEL
Last Name:HAFFORD
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 1:612 WILLOWDALE BLVD
Mailing Address - Street 2:
Mailing Address - City:LULING
Mailing Address - State:LA
Mailing Address - Zip Code:70070-3118
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:111 LAKEWOOD DR
Practice Address - Street 2:SUITE A
Practice Address - City:LULING
Practice Address - State:LA
Practice Address - Zip Code:70070-3002
Practice Address - Country:US
Practice Address - Phone:985-785-6838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-20
Last Update Date:2011-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA61541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice