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General NPI Number Information
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NPI Number | 1134568884
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Entity Type | Individual
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Provider Name | FERAS TAHER ALKHADER DDS
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Gender | Male
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Dates
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Enumeration Date | 06/17/2013
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Last Update Date | 04/22/2015
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Provider Practice Location Address
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Address Line | 2207 GUNNELLS LN
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City | OXFORD
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State | AL
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Zip | 36203-3613
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Country | US
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Telephone | 256-499-0080
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Fax |
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Provider Business Mailing Address
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Address Line | 1721 S MAIN ST
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City | WEST BEND
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State | WI
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Zip | 53095-4937
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Country | US
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Telephone | 256-499-0080
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 1001020-15
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License Number State | WI
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