Provider Demographics
NPI:1821020397
Name:HADAR, BENJAMIN (DMD)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:
Last Name:HADAR
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 BOW ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02420-3003
Mailing Address - Country:US
Mailing Address - Phone:781-860-7700
Mailing Address - Fax:781-860-7710
Practice Address - Street 1:3 BOW ST
Practice Address - Street 2:SUITE 2
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02420-3003
Practice Address - Country:US
Practice Address - Phone:781-860-7700
Practice Address - Fax:781-860-7710
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA192131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice