Provider Demographics
NPI:1427123603
Name:HADEED, PETER DAVID (DDS)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:DAVID
Last Name:HADEED
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:925 RUSSELL AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20879-3252
Mailing Address - Country:US
Mailing Address - Phone:301-330-5000
Mailing Address - Fax:301-948-8555
Practice Address - Street 1:925 RUSSELL AVE
Practice Address - Street 2:SUITE A
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20879-3252
Practice Address - Country:US
Practice Address - Phone:301-330-5000
Practice Address - Fax:301-948-8555
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD93571223P0300X, 1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1223P0300XDental ProvidersDentistPeriodontics
Not Answered1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics