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General NPI Number Information
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NPI Number | 1790592566
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Entity Type | Individual
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Provider Name | WESSAM WASEF DMD
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Gender | Male
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Dates
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Enumeration Date | 12/16/2024
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Last Update Date | 12/16/2024
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Provider Practice Location Address
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Address Line | 153 WORTH GUARD RD
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City | COINJOCK
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State | NC
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Zip | 27923-9766
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Country | US
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Telephone | 252-453-2181
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Fax |
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Provider Business Mailing Address
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Address Line | 102 MCCALL CT
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City | HAMPTON
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State | VA
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Zip | 23666-4536
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Country | US
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Telephone | 207-415-7685
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 14024
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License Number State | NC
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