Healthcare Provider Details

I. General information

NPI: 1275622581
Provider Name (Legal Business Name): NAVID H HADIAN DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

979 BROOKSIDE RD
WESCOSVILLE PA
18106-9441
US

IV. Provider business mailing address

979 BROOKSIDE RD
WESCOSVILLE PA
18106-9441
US

V. Phone/Fax

Practice location:
  • Phone: 610-395-1630
  • Fax: 610-395-9117
Mailing address:
  • Phone: 610-395-1630
  • Fax: 610-395-9117

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDS029302L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: