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General NPI Number Information
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NPI Number | 1912517111
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Entity Type | Organization
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Legal Business Name | BD DENTAL LLC
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Dates
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Enumeration Date | 08/03/2020
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Last Update Date | 08/03/2020
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Provider Practice Location Address
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Address Line | 3639 KIESSEL RD
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City | THE VILLAGES
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State | FL
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Zip | 32163-2909
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Country | US
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Telephone | 352-350-7445
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Fax | 352-350-7726
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Provider Business Mailing Address
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Address Line | 3639 KIESSEL RD
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City | THE VILLAGES
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State | FL
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Zip | 32163-2909
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Country | US
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Telephone | 352-350-7445
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Fax | 352-350-7726
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. FADI R AOUN
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Credential | DMD
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Telephone | 407-529-8482
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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