Provider Demographics
NPI:1154528842
Name:HABER, VIVIANE SAYEGH (DDS)
Entity type:Individual
Prefix:DR
First Name:VIVIANE
Middle Name:SAYEGH
Last Name:HABER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 W BASELINE RD STE C
Mailing Address - Street 2:
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91740-4817
Mailing Address - Country:US
Mailing Address - Phone:626-335-1211
Mailing Address - Fax:626-608-0363
Practice Address - Street 1:420 W BASELINE RD STE C
Practice Address - Street 2:
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91740-4817
Practice Address - Country:US
Practice Address - Phone:626-335-1211
Practice Address - Fax:626-608-0363
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33988122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist