Provider Demographics
NPI:1174359301
Name:DR HAMZA TARIQ DDS PLLC
Entity type:Organization
Organization Name:DR HAMZA TARIQ DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:HAMZA
Authorized Official - Middle Name:
Authorized Official - Last Name:TARIQ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:347-659-3519
Mailing Address - Street 1:4519 CHESTNUT ST UNIT 242
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19139-3899
Mailing Address - Country:US
Mailing Address - Phone:347-659-3519
Mailing Address - Fax:
Practice Address - Street 1:801 UPLAND AVE APT B
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19013-4902
Practice Address - Country:US
Practice Address - Phone:347-659-3519
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-12
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty