Provider Demographics
NPI:1174814156
Name:H & K DENTAL SERVICES ,PLC
Entity Type:Organization
Organization Name:H & K DENTAL SERVICES ,PLC
Other - Org Name:FAIR HAVEN DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FADI
Authorized Official - Middle Name:JAMIL
Authorized Official - Last Name:HAWWASH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:802-265-3604
Mailing Address - Street 1:PO BOX 37
Mailing Address - Street 2:
Mailing Address - City:FAIR HAVEN
Mailing Address - State:VT
Mailing Address - Zip Code:05743-0037
Mailing Address - Country:US
Mailing Address - Phone:802-265-3604
Mailing Address - Fax:802-251-0022
Practice Address - Street 1:129B N MAIN ST
Practice Address - Street 2:
Practice Address - City:FAIR HAVEN
Practice Address - State:VT
Practice Address - Zip Code:05743-1132
Practice Address - Country:US
Practice Address - Phone:802-265-3604
Practice Address - Fax:802-251-0022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-26
Last Update Date:2011-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental