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General NPI Number Information
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NPI Number | 1598038192
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Entity Type | Individual
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Provider Name | FADI HASAN DDS
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Gender | Male
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Dates
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Enumeration Date | 02/14/2012
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Last Update Date | 03/05/2012
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Provider Practice Location Address
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Address Line | 2200 N WESTMORELAND ST APT 524
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City | ARLINGTON
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State | VA
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Zip | 22213-1044
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Country | US
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Telephone | 617-386-9774
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Fax |
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Provider Business Mailing Address
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Address Line | 2200 N WESTMORELAND ST APT 524
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City | ARLINGTON
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State | VA
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Zip | 22213-1044
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Country | US
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Telephone | 617-386-9774
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 0401413459
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License Number State | VA
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