Provider Demographics
NPI:1558644336
Name:NAAS, HAITEM (DMD)
Entity Type:Individual
Prefix:DR
First Name:HAITEM
Middle Name:
Last Name:NAAS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 REGENT ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02119-1905
Mailing Address - Country:US
Mailing Address - Phone:206-359-1171
Mailing Address - Fax:
Practice Address - Street 1:100 E NEWTON ST # G219
Practice Address - Street 2:ROOM #214
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-2308
Practice Address - Country:US
Practice Address - Phone:206-359-1171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-27
Last Update Date:2015-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADL125401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice