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General NPI Number Information
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NPI Number | 1922824259
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Entity Type | Individual
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Provider Name | SYED FAZEEL HASSAN DMD
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Gender | Male
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Dates
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Enumeration Date | 12/03/2024
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Last Update Date | 06/05/2025
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Provider Practice Location Address
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Address Line | 2154 GOODMAN RD W # 1
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City | HORN LAKE
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State | MS
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Zip | 38637-1303
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Country | US
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Telephone | 662-393-9200
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Fax |
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Provider Business Mailing Address
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Address Line | 1321 NW 91ST TER
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City | GAINESVILLE
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State | FL
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Zip | 32606-5529
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Country | US
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Telephone | 352-213-4172
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 111167
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License Number State | MS
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