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General NPI Number Information
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NPI Number | 1013024397
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Entity Type | Individual
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Provider Name | KONSTANTINE N/A SAYAF D.M.D
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Gender | Male
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Dates
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Enumeration Date | 08/24/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1147 EDGEWOOD AVE S
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City | JACKSONVILLE
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State | FL
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Zip | 32205-0810
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Country | US
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Telephone | 904-388-1421
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Fax | 904-387-5109
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Provider Business Mailing Address
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Address Line | 321 N LOMBARDY LOOP
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City | JACKSONVILLE
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State | FL
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Zip | 32259-5268
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Country | US
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Telephone | 904-307-0767
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Fax | 904-387-5109
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 15326
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License Number State | FL
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