Provider Demographics
NPI:1124450663
Name:BITAR, GEORGE A (DMD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:A
Last Name:BITAR
Suffix:
Gender:M
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:CMR 402 BOX 679
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09180-0007
Mailing Address - Country:US
Mailing Address - Phone:314-590-7979
Mailing Address - Fax:
Practice Address - Street 1:DENTAL HEALTH ACTIVITY-RP
Practice Address - Street 2:UNIT 33301
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09180-3301
Practice Address - Country:US
Practice Address - Phone:314-590-6588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-07
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN111831223S0112X
NV6444122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No122300000XDental ProvidersDentist