Provider Demographics
NPI:1497886469
Name:HADDAD, RAMI M (DDS)
Entity Type:Individual
Prefix:DR
First Name:RAMI
Middle Name:M
Last Name:HADDAD
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 1:43535 GADSDEN AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-6147
Mailing Address - Country:US
Mailing Address - Phone:661-942-6522
Mailing Address - Fax:661-942-2677
Practice Address - Street 1:43535 GADSDEN AVE
Practice Address - Street 2:SUITE B
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-6147
Practice Address - Country:US
Practice Address - Phone:661-942-6522
Practice Address - Fax:661-942-2677
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAB443181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice