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General NPI Number Information
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NPI Number | 1952060881
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Entity Type | Organization
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Legal Business Name | ROYAL DENTAL LLC
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Dates
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Enumeration Date | 12/08/2021
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Last Update Date | 12/08/2021
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Provider Practice Location Address
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Address Line | 2335 STATE AVE STE A
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City | PANAMA CITY
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State | FL
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Zip | 32405-4379
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Country | US
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Telephone | 850-740-3100
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Fax | 850-640-0636
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Provider Business Mailing Address
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Address Line | 2335 STATE AVE STE A
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City | PANAMA CITY
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State | FL
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Zip | 32405-4379
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Country | US
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Telephone | 850-740-3100
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Fax | 850-640-0636
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Authorized Official
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Title or Position | DENTIST
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Name | DR. YAHIA ABDULRAHIM
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Credential | D.D.S
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Telephone | 850-740-3100
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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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