BRENT ERIC HAVEY

PETERSON AFB, CO
NPI1003895996
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy122300000X Dentist
(Licence: CO  7909)
Additional Taxonomies122300000X Dentist
(Licence: WI  5032-015)
Enumeration Date2006-01-10
Last Update Date2009-03-13
Business Address
-- BRENT ERIC HAVEY DDS
1045 E. STEWART, BLDG 1045 T
PETERSON AFB, CO 80914-1540
Phone number: 719-556-1333
Mailing Address
-- BRENT ERIC HAVEY DDS
559 VINCENT STREET ATTN: 21 SGGD - DENTAL SQUADRON
PETERSON AFB, CO 80914-1540
Phone number: 719-556-1333
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