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General NPI Number Information
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NPI Number | 1649324112
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Entity Type | Individual
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Provider Name | ALEXANDRE GHAZAL DMD
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Gender | Male
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 08/05/2016
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Provider Practice Location Address
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Address Line | 1950 LAUREL MANOR DR BLDG#184
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City | THE VILLAGES
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State | FL
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Zip | 32162-5603
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Country | US
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Telephone | 352-753-0150
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Fax | 352-750-8072
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Provider Business Mailing Address
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Address Line | 1950 LAUREL MANOR DR BLDG#184
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City | THE VILLAGES
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State | FL
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Zip | 32162-5603
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Country | US
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Telephone | 352-753-0150
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Fax | 352-750-8072
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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 | 15659
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License Number State | FL
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