Provider Demographics
NPI:1356462774
Name:HAJJAR, GEORGE PHILIP (DDS)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:PHILIP
Last Name:HAJJAR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9000 FOOTHILL BLVD STE 114
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-3457
Mailing Address - Country:US
Mailing Address - Phone:909-980-7888
Mailing Address - Fax:909-989-9964
Practice Address - Street 1:9000 FOOTHILL BLVD STE 114
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-3457
Practice Address - Country:US
Practice Address - Phone:909-980-7888
Practice Address - Fax:909-989-9964
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA303941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice