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General NPI Number Information
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NPI Number | 1912371808
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Entity Type | Individual
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Provider Name | MAHER HAJJAJ BDS, MSD, FRCDC, DSC
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Gender | Male
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Dates
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Enumeration Date | 11/16/2015
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Last Update Date | 11/16/2015
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Provider Practice Location Address
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Address Line | 100 E NEWTON ST ROOM G716
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City | BOSTON
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State | MA
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Zip | 02118-2308
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Country | US
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Telephone | 617-638-4636
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Fax | 617-638-5322
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Provider Business Mailing Address
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Address Line | 8 9TH ST APT 304
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City | MEDFORD
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State | MA
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Zip | 02155-5144
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Country | US
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Telephone | 317-531-3512
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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 | BB1832268AMJJ1
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License Number State | MA
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