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Provider Information for 1104075944



DR. DAVID HAZAN DMD, B.ENG

Gender: MALE

Individual NPI: 1104075944

Calendar Last Updated: 2008-09-17

Details

Name Value
NPI 1104075944
Enumeration Date 2008-09-17
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 385 DOUGLAS AVE SUITE 2450
ALTAMONTE SPRINGS, FL 32714-3325
United States

Phone: 407-677-5400 | Fax: 407-677-5402
View Map External Link
Primary Practice Address 385 DOUGLAS AVE SUITE 2450
ALTAMONTE SPRINGS, FL 32714-3325
United States

Phone: 407-677-5400 | Fax: 407-677-5402
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 122300000X - Dentist FL DN14745