Provider Demographics
NPI:1760554372
Name:JABR, HADEN H (DDS)
Entity Type:Individual
Prefix:DR
First Name:HADEN
Middle Name:H
Last Name:JABR
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 1:3806 N 24TH ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-6513
Mailing Address - Country:US
Mailing Address - Phone:602-955-6400
Mailing Address - Fax:602-553-0524
Practice Address - Street 1:3806 N 24TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-6513
Practice Address - Country:US
Practice Address - Phone:602-955-6400
Practice Address - Fax:602-553-0524
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ48541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice