Provider Demographics
NPI:1205978418
Name:KATTAR, JEAN MAROUN (DDS)
Entity type:Individual
Prefix:MR
First Name:JEAN
Middle Name:MAROUN
Last Name:KATTAR
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 1:1141 E ALOSTA AVE
Mailing Address - Street 2:
Mailing Address - City:AZUSA
Mailing Address - State:CA
Mailing Address - Zip Code:91702-2740
Mailing Address - Country:US
Mailing Address - Phone:626-335-8000
Mailing Address - Fax:626-335-1333
Practice Address - Street 1:1141 E ALOSTA AVE
Practice Address - Street 2:
Practice Address - City:AZUSA
Practice Address - State:CA
Practice Address - Zip Code:91702-2740
Practice Address - Country:US
Practice Address - Phone:626-335-8000
Practice Address - Fax:626-335-1333
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39973122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist