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General NPI Number Information
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NPI Number | 1760355713
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Entity Type | Organization
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Legal Business Name | FADI ROUEL DMD, INC
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Dates
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Enumeration Date | 09/25/2025
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Last Update Date | 09/25/2025
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Provider Practice Location Address
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Address Line | 895 JACKMAN ST
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City | EL CAJON
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State | CA
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Zip | 92020-3052
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Country | US
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Telephone | 619-345-6115
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Fax |
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Provider Business Mailing Address
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Address Line | 895 JACKMAN ST
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City | EL CAJON
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State | CA
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Zip | 92020-3052
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Country | US
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Telephone | 619-345-6115
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | FADI ROUEL
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Credential | DMD
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Telephone | 352-275-7785
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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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