Provider Demographics
NPI:1518221209
Name:HAFFAR, MARIA (DDS)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:HAFFAR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2232 N CLYBOURN AVE FL 3
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-3193
Mailing Address - Country:US
Mailing Address - Phone:773-269-5540
Mailing Address - Fax:312-491-5485
Practice Address - Street 1:1431 N WESTERN AVE STE 401
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-1797
Practice Address - Country:US
Practice Address - Phone:773-269-5540
Practice Address - Fax:773-269-5542
Is Sole Proprietor?:No
Enumeration Date:2012-06-27
Last Update Date:2018-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019031501122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist