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General NPI Number Information
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NPI Number | 1689939159
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Entity Type | Organization
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Legal Business Name | A.K.M.W.ISLAM,BDS,P.A.
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Dates
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Enumeration Date | 07/10/2012
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Last Update Date | 07/10/2012
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Provider Practice Location Address
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Address Line | 1925 E MICHIGAN ST SUITE 101
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City | ORLANDO
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State | FL
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Zip | 32806-4978
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Country | US
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Telephone | 407-896-6336
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Fax |
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Provider Business Mailing Address
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Address Line | 1925 E MICHIGAN ST SUITE 101
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City | ORLANDO
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State | FL
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Zip | 32806-4978
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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 | PRESIDENT
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Name | DR. ABUL K ISLAM
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Credential |
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Telephone | 407-896-6336
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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 | 11823
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License Number State | FL
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