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General NPI Number Information
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NPI Number | 1851967723
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Entity Type | Individual
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Provider Name | MUSTAFA ADEL DMD
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Gender | Male
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Dates
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Enumeration Date | 06/01/2021
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Last Update Date | 08/07/2024
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Provider Practice Location Address
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Address Line | 3641 MADACA LN
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City | TAMPA
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State | FL
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Zip | 33618-2048
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Country | US
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Telephone | 813-964-8585
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Fax |
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Provider Business Mailing Address
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Address Line | 9450 LARKBUNTING DR
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City | TAMPA
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State | FL
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Zip | 33647-2822
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Country | US
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Telephone | 813-735-8507
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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 | DN26440
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License Number State | FL
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