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General NPI Number Information
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NPI Number | 1336885482
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Entity Type | Organization
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Legal Business Name | INCISOR ADVISOR LLC
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Dates
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Enumeration Date | 05/11/2022
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Last Update Date | 05/11/2022
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Provider Practice Location Address
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Address Line | 3890 DAVIE RD STE 171
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City | DAVIE
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State | FL
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Zip | 33314-2579
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Country | US
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Telephone | 682-554-8563
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Fax |
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Provider Business Mailing Address
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Address Line | 3890 DAVIE RD STE 111
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City | DAVIE
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State | FL
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Zip | 33314-2581
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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 | DENTIST/PARTNER
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Name | DR. OMAIR KHAN
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Credential | DMD
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Telephone | 682-554-8563
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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 |
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License Number State |
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