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General NPI Number Information
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NPI Number | 1306341375
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Entity Type | Individual
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Provider Name | MINA DAVID FAHMY DDS
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Gender | Male
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Dates
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Enumeration Date | 03/29/2018
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Last Update Date | 06/12/2022
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Provider Practice Location Address
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Address Line | 33 TRAFALGAR SQ STE 201
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City | NASHUA
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State | NH
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Zip | 03063-4901
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Country | US
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Telephone | 603-821-9001
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Fax |
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Provider Business Mailing Address
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Address Line | 1924 ALCOA HWY # U-63
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City | KNOXVILLE
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State | TN
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Zip | 37920-1511
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Country | US
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Telephone | 865-305-9123
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Fax | 865-305-4501
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number | 04703
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License Number State | NH
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