Individual
DR. ALBERT A HAZZOURI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S,M.S.
Contact information
Practice address
600 LACKAWANNA AVE, SCRANTON, PA 18503-2046
(570) 342-9136
(570) 344-0299
Mailing address
600 LACKAWANNA AVE, SCRANTON, PA 18503-2046
(570) 342-9136
(570) 344-0299
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS024299L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
149626
UNITED CONCORDIA PROVIDER
PA
Enumeration date
10/04/2006
Last updated
07/08/2007
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