Provider Demographics
NPI:1679641401
Name:HARBOUR VIEW DENTAL ASSOCIATES, PC
Entity Type:Organization
Organization Name:HARBOUR VIEW DENTAL ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIELA
Authorized Official - Middle Name:L
Authorized Official - Last Name:HIJAZIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:914-381-0778
Mailing Address - Street 1:133 FENIMORE RD
Mailing Address - Street 2:
Mailing Address - City:MAMARONECK
Mailing Address - State:NY
Mailing Address - Zip Code:10543-3502
Mailing Address - Country:US
Mailing Address - Phone:914-381-0778
Mailing Address - Fax:914-381-5678
Practice Address - Street 1:133 FENIMORE RD
Practice Address - Street 2:
Practice Address - City:MAMARONECK
Practice Address - State:NY
Practice Address - Zip Code:10543-3502
Practice Address - Country:US
Practice Address - Phone:914-381-0778
Practice Address - Fax:914-381-5678
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0491401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty