Provider Demographics
NPI:1114371184
Name:HADEEN, DENNIS (PHARMD)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:
Last Name:HADEEN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1977 W CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93637-8705
Mailing Address - Country:US
Mailing Address - Phone:559-559-6757
Mailing Address - Fax:559-675-7005
Practice Address - Street 1:1977 W CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93637-8705
Practice Address - Country:US
Practice Address - Phone:559-559-6757
Practice Address - Fax:559-675-7005
Is Sole Proprietor?:No
Enumeration Date:2016-04-15
Last Update Date:2016-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45147183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist