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General NPI Number Information
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NPI Number | 1679064950
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Entity Type | Individual
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Provider Name | HAYDER A KAFAJI DDS
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Gender | Male
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Dates
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Enumeration Date | 05/23/2018
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Last Update Date | 10/06/2022
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Provider Practice Location Address
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Address Line | 8529 GUNN HWY
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City | ODESSA
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State | FL
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Zip | 33556-3288
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Country | US
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Telephone | 603-785-4662
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Fax |
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Provider Business Mailing Address
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Address Line | 28540 TRANQUIL LAKE CIR
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City | WESLEY CHAPEL
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State | FL
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Zip | 33543-6589
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Country | US
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Telephone | 603-785-4662
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN23989
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License Number State | FL
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