Provider Demographics
NPI:1801239314
Name:CHARLES D. HASSE, D.D.S., INC.
Entity type:Organization
Organization Name:CHARLES D. HASSE, D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:D
Authorized Official - Last Name:HASSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-727-7000
Mailing Address - Street 1:16300 SAND CANYON AVE
Mailing Address - Street 2:SUITE 711
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3711
Mailing Address - Country:US
Mailing Address - Phone:949-727-7000
Mailing Address - Fax:949-727-3924
Practice Address - Street 1:16300 SAND CANYON AVE
Practice Address - Street 2:SUITE 711
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3711
Practice Address - Country:US
Practice Address - Phone:949-727-7000
Practice Address - Fax:949-727-3924
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-15
Last Update Date:2013-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28568261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical