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General NPI Number Information
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NPI Number | 1669785994
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Entity Type | Organization
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Legal Business Name | HALEH AZAR, D.M.D., P.C.
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Dates
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Enumeration Date | 07/15/2010
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Last Update Date | 07/15/2010
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Provider Practice Location Address
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Address Line | 3 HARVARD AVE
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City | BROOKLINE
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State | MA
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Zip | 02446-6295
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Country | US
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Telephone | 617-738-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 3 HARVARD AVE
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City | BROOKLINE
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State | MA
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Zip | 02446-6295
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Country | US
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Telephone | 617-738-5000
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Fax |
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Authorized Official
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Title or Position | PRESIENT/ORTHODONTIST
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Name | DR. HALEH AZAR
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Credential | D.M.D.
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Telephone | 617-549-7455
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 18008
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License Number State | MA
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