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General NPI Number Information
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NPI Number | 1174359301
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Entity Type | Organization
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Legal Business Name | DR HAMZA TARIQ DDS PLLC
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Dates
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Enumeration Date | 09/12/2024
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Last Update Date | 09/12/2024
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Provider Practice Location Address
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Address Line | 801 UPLAND AVE APT B
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City | CHESTER
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State | PA
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Zip | 19013-4902
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Country | US
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Telephone | 347-659-3519
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Fax |
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Provider Business Mailing Address
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Address Line | 4519 CHESTNUT ST UNIT 242
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City | PHILADELPHIA
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State | PA
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Zip | 19139-3899
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Country | US
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Telephone | 347-659-3519
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | HAMZA TARIQ
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Credential | DDS
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Telephone | 347-659-3519
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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