Provider Demographics
NPI:1992829196
Name:HABJAN, DENISE (D,D,S,)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:
Last Name:HABJAN
Suffix:
Gender:F
Credentials:D,D,S,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:999 N. TUSTIN AVE. #219
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705
Mailing Address - Country:US
Mailing Address - Phone:714-972-1359
Mailing Address - Fax:714-972-2689
Practice Address - Street 1:999 N. TUSTIN AVE. #219
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705
Practice Address - Country:US
Practice Address - Phone:714-972-1359
Practice Address - Fax:714-972-2689
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA302461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice