Provider Demographics
NPI:1720328511
Name:GEORGE P & HARRIET H HAJJAR FAMILY DENTISTRY (A CA GENERAL PARTNERSHIP
Entity Type:Organization
Organization Name:GEORGE P & HARRIET H HAJJAR FAMILY DENTISTRY (A CA GENERAL PARTNERSHIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:HARRIET
Authorized Official - Middle Name:HARITAKIS
Authorized Official - Last Name:HAJJAR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:909-980-7888
Mailing Address - Street 1:9000 FOOTHILL BLVD STE 114
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-3457
Mailing Address - Country:US
Mailing Address - Phone:909-980-7888
Mailing Address - Fax:909-989-9964
Practice Address - Street 1:9000 FOOTHILL BLVD STE 114
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-3457
Practice Address - Country:US
Practice Address - Phone:909-980-7888
Practice Address - Fax:909-989-9964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-15
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30394122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty