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General NPI Number Information
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NPI Number | 1053329995
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Entity Type | Individual
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Provider Name | ABDUL MAJID AZIZI DMD
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Gender | Male
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Dates
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Enumeration Date | 08/04/2006
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Last Update Date | 06/04/2013
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Provider Practice Location Address
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Address Line | 19051 US HIGHWAY 441 STE 100
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City | MOUNT DORA
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State | FL
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Zip | 32757-6708
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Country | US
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Telephone | 352-735-5005
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Fax |
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Provider Business Mailing Address
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Address Line | 801 CHAMPION WOODS CT
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City | SANFORD
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State | FL
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Zip | 32771-7164
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Country | US
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Telephone | 407-756-7172
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Fax |
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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 | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | DN15621
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License Number State | FL
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