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General NPI Number Information
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NPI Number | 1316623994
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Entity Type | Individual
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Provider Name | FATIMA AZAM BUTT DDS
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Gender | Female
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Dates
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Enumeration Date | 06/27/2023
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Last Update Date | 12/10/2024
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Provider Practice Location Address
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Address Line | 1382 HOWLAND BLVD STE 104
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City | DELTONA
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State | FL
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Zip | 32738-9739
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Country | US
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Telephone | 484-908-8018
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Fax |
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Provider Business Mailing Address
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Address Line | 1382 HOWLAND BLVD STE 104
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City | DELTONA
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State | FL
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Zip | 32738-9739
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Country | US
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Telephone |
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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 | DN28274
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License Number State | FL
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