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General NPI Number Information
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NPI Number | 1477392421
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Entity Type | Organization
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Legal Business Name | ABLE DENTAL LLC
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Dates
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Enumeration Date | 05/20/2024
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Last Update Date | 05/20/2024
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Provider Practice Location Address
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Address Line | 1248 SEVEN SPRINGS BLVD STE B
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City | NEW PORT RICHEY
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State | FL
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Zip | 34655-5652
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Country | US
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Telephone | 727-816-9800
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Fax |
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Provider Business Mailing Address
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Address Line | 8934 FORGE BREEZE LOOP
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City | WESLEY CHAPEL
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State | FL
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Zip | 33545-2331
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Country | US
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Telephone | 954-903-8587
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MOHIUDDIN IFAZ
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Credential | DMD
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Telephone | 954-903-8587
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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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