MEDICARE: BRITTANY HADDAD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	30.24754	OH

General Provider Information

NPI Number	:	1730536657
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITTANY HADDAD

Provider Business Mailing Address
First Line	:	13907 CEDAR RD
Second Line	:
City	:	UNIVERSITY HEIGHTS
State	:	OH
Zip	:	44118-3203
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	13907 CEDAR RD
Second Line	:
City	:	UNIVERSITY HEIGHTS
State	:	OH
Zip	:	44118-3203
Country	:	US
Telephone Number	:	216-485-3216
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/20/2016
Last Update Date	:	01/02/2017

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Directions to “ BRITTANY HADDAD ” Practice Location

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