Healthcare Provider Details

I. General information

NPI: 1215235924
Provider Name (Legal Business Name): NABIL S HANNA DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: NABIL H SAAD DDS

II. Dates (important events)

Enumeration Date: 03/03/2011
Last Update Date: 02/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 W AIRPORT BLVD
SANFORD FL
32773-5489
US

IV. Provider business mailing address

400 W AIRPORT BLVD
SANFORD FL
32773-5489
US

V. Phone/Fax

Practice location:
  • Phone: 407-665-3200
  • Fax: 407-665-3213
Mailing address:
  • Phone: 407-665-3345
  • Fax: 407-665-3034

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN8976
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: