Provider Demographics
NPI:1841352382
Name:HADDAD, JEFFREY S (DDS)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:S
Last Name:HADDAD
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 1:433 W UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MI
Mailing Address - Zip Code:48307-1943
Mailing Address - Country:US
Mailing Address - Phone:248-656-2020
Mailing Address - Fax:248-656-2559
Practice Address - Street 1:433 W UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MI
Practice Address - Zip Code:48307-1943
Practice Address - Country:US
Practice Address - Phone:248-656-2020
Practice Address - Fax:248-656-2559
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI182531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice