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General NPI Number Information
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NPI Number | 1528461191
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Entity Type | Organization
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Legal Business Name | NADEEM U HASEEB, DDS A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 09/26/2014
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Last Update Date | 09/26/2014
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Provider Practice Location Address
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Address Line | 1722 SWEETWATER RD SUITE C
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City | NATIONAL CITY
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State | CA
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Zip | 91950-7646
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Country | US
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Telephone | 619-336-1974
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Fax | 619-336-1976
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Provider Business Mailing Address
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Address Line | 1722 SWEETWATER RD SUITE C
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City | NATIONAL CITY
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State | CA
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Zip | 91950-7646
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Country | US
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Telephone | 619-336-1974
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Fax | 619-336-1976
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Authorized Official
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Title or Position | PRACTICE OWNER
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Name | NADEM U HASEEB
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Credential |
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Telephone | 619-336-1974
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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 | 52294
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License Number State | CA
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