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General NPI Number Information
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NPI Number | 1720328511
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Entity Type | Organization
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Legal Business Name | GEORGE P & HARRIET H HAJJAR FAMILY DENTISTRY (A CA GENERAL PARTNERSHIP
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Dates
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Enumeration Date | 02/15/2013
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Last Update Date | 11/04/2021
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Provider Practice Location Address
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Address Line | 9000 FOOTHILL BLVD STE 114
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-3457
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Country | US
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Telephone | 909-980-7888
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Fax | 909-989-9964
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Provider Business Mailing Address
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Address Line | 9000 FOOTHILL BLVD STE 114
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-3457
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Country | US
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Telephone | 909-980-7888
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Fax | 909-989-9964
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Authorized Official
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Title or Position | PARTNER
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Name | HARRIET HARITAKIS HAJJAR
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Credential | DDS
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Telephone | 909-980-7888
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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 | 30394
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License Number State | CA
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