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General NPI Number Information
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NPI Number | 1912794488
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Entity Type | Organization
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Legal Business Name | H & O DENTAL LLC
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Dates
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Enumeration Date | 04/21/2025
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Last Update Date | 04/21/2025
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Provider Practice Location Address
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Address Line | 1250 W EAU GALLIE BLVD STE C
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City | MELBOURNE
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State | FL
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Zip | 32935-5385
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Country | US
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Telephone | 305-900-0873
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Fax |
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Provider Business Mailing Address
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Address Line | 3886 BEECHGROVE RD
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City | MELBOURNE
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State | FL
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Zip | 32934-8542
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Country | US
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Telephone | 786-783-2826
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. HANZARA PANOL
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Credential | DMD
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Telephone | 305-900-0873
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X2210X
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Taxonomy Name | Orofacial Pain Dentistry
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License Number |
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License Number State |
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