Individual
OMID HADJ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(888) 584-7888
Mailing address
3410 SHADOW SPRING CT, HOUSTON, TX 77082-8302
(832) 474-0209
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
019.033710
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/21/2022
Last updated
06/06/2022
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