Milburn S. Haynes, D.D.S., P.A.
Dentist, General Practice in Texarkana, TX. Organization (NPI-2).
NPI number1184635187
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1184635187
- Entity type
- Organization (NPI-2)
- Legal business name
- Milburn S. Haynes, D.D.S., P.A.
- Organization subpart
- No
- Enumeration date
- Aug 11, 2006
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 19602 | TX | Yes |
Other names
- Pleasant Grove Family Dentistry (Other Name)
Practice location
4330 McKnight RdTexarkana, TX 75503-0923
Phone 903-838-9700
Mailing address
4330 McKnight RdTexarkana, TX 75503-0923
Phone 903-838-9700
Authorized official
Milburn Sidney Haynes
Owner/Dentist
9038389700
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