Provider Demographics
NPI:1740734672
Name:HASBUN, JOEL ANDREW (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:ANDREW
Last Name:HASBUN
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 1:16 ABINGTON RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-4719
Mailing Address - Country:US
Mailing Address - Phone:609-458-3405
Mailing Address - Fax:
Practice Address - Street 1:141 TUCKAHOE RD
Practice Address - Street 2:
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-3844
Practice Address - Country:US
Practice Address - Phone:856-422-5200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-09
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02645500122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist