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General NPI Number Information
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NPI Number | 1528414588
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Entity Type | Organization
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Legal Business Name | MARIAM M. HABIB, D.D.S., L.L.C.
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Dates
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Enumeration Date | 05/09/2016
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Last Update Date | 05/09/2016
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Provider Practice Location Address
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Address Line | 801 PAUL ST
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City | ORLANDO
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State | FL
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Zip | 32808-7544
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Country | US
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Telephone | 407-290-0367
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Fax |
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Provider Business Mailing Address
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Address Line | 801 PAUL ST
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City | ORLANDO
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State | FL
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Zip | 32808-7544
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Country | US
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Telephone | 407-290-0367
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARIAM HABIB
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Credential | D.D.S.
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Telephone | 407-290-0367
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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 | DN20984
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License Number State | FL
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