Healthcare Provider Details

I. General information

NPI: 1255777801
Provider Name (Legal Business Name): UNMOAL RASHID D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2013
Last Update Date: 08/28/2024
Certification Date: 08/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13018 US 301 S
RIVERVIEW FL
33578-7420
US

IV. Provider business mailing address

100 FLORIDA ST
CHARLESTON WV
25302-1131
US

V. Phone/Fax

Practice location:
  • Phone: 813-445-8451
  • Fax:
Mailing address:
  • Phone: 304-348-6613
  • Fax: 304-348-1394

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN26645
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: