Provider Demographics
NPI:1871790469
Name:JAY F HAUSER DDS PC D/B/A PREMIER DENTAL PARTNERS
Entity type:Organization
Organization Name:JAY F HAUSER DDS PC D/B/A PREMIER DENTAL PARTNERS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:INSURANCE COORD.
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDREWS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-361-0760
Mailing Address - Street 1:22 N EUCLID AVE
Mailing Address - Street 2:SUITE 220
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63108-1407
Mailing Address - Country:US
Mailing Address - Phone:314-361-0760
Mailing Address - Fax:314-367-7702
Practice Address - Street 1:22 N EUCLID AVE
Practice Address - Street 2:SUITE 220
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63108-1407
Practice Address - Country:US
Practice Address - Phone:314-361-0760
Practice Address - Fax:314-367-7702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-28
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty