Provider Demographics
NPI:1912371808
Name:HAJJAJ, MAHER (BDS, MSD, FRCDC, DSC)
Entity Type:Individual
Prefix:DR
First Name:MAHER
Middle Name:
Last Name:HAJJAJ
Suffix:
Gender:M
Credentials:BDS, MSD, FRCDC, DSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 9TH ST APT 304
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155-5144
Mailing Address - Country:US
Mailing Address - Phone:317-531-3512
Mailing Address - Fax:
Practice Address - Street 1:100 E NEWTON ST
Practice Address - Street 2:ROOM G716
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-2308
Practice Address - Country:US
Practice Address - Phone:617-638-4636
Practice Address - Fax:617-638-5322
Is Sole Proprietor?:No
Enumeration Date:2015-11-16
Last Update Date:2015-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MABB1832268AMJJ1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist