Provider Demographics
NPI:1528183134
Name:AZDAIR, JAIME ALBERT (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAIME
Middle Name:ALBERT
Last Name:AZDAIR
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 1:330 N GARFIELD AVE
Mailing Address - Street 2:SUITE #4
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-2400
Mailing Address - Country:US
Mailing Address - Phone:626-282-3648
Mailing Address - Fax:626-284-0073
Practice Address - Street 1:330 N GARFIELD AVE
Practice Address - Street 2:SUITE #4
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-2400
Practice Address - Country:US
Practice Address - Phone:626-282-3648
Practice Address - Fax:626-284-0073
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA292071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice