Provider Demographics
NPI:1043016496
Name:PETER F. HAZIM D.D.S., P.A.
Entity type:Organization
Organization Name:PETER F. HAZIM D.D.S., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:HAZIM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-727-5599
Mailing Address - Street 1:105 N ALMA DR STE 100
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-3360
Mailing Address - Country:US
Mailing Address - Phone:972-727-5599
Mailing Address - Fax:972-727-5592
Practice Address - Street 1:105 N ALMA DR STE 100
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-3360
Practice Address - Country:US
Practice Address - Phone:972-727-5599
Practice Address - Fax:972-727-5592
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-24
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty