Individual
ADISA HAMATAJ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
9915 W MCDOWELL RD # ARE106, AVONDALE, AZ 85392-4896
(623) 907-4562
Mailing address
6975 E PRINCESS DR APT 3120, PHOENIX, AZ 85054-4234
(917) 664-5944
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
2016013929
MO
1223G0001X
General Practice Dentistry
Primary
D010375
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/30/2016
Last updated
07/30/2019
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