Provider Demographics
NPI:1265710248
Name:HARDAN, SAMIA A (DMD)
Entity type:Individual
Prefix:DR
First Name:SAMIA
Middle Name:A
Last Name:HARDAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:533 ANNADALE DR
Mailing Address - Street 2:
Mailing Address - City:BERWYN
Mailing Address - State:PA
Mailing Address - Zip Code:19312-1974
Mailing Address - Country:US
Mailing Address - Phone:610-731-8858
Mailing Address - Fax:
Practice Address - Street 1:533 ANNADALE DR
Practice Address - Street 2:
Practice Address - City:BERWYN
Practice Address - State:PA
Practice Address - Zip Code:19312-1974
Practice Address - Country:US
Practice Address - Phone:610-731-8858
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-25
Last Update Date:2011-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0387601223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics