MEDICARE: DR. MOHAMMAD NOURI AL-NAHHAS DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0700X	Prosthodontics	DN12472	FL

General Provider Information

NPI Number	:	1275665416
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MOHAMMAD NOURI AL-NAHHAS DDS

Provider Business Mailing Address
First Line	:	1714 W 23RD ST STE P
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32405-2924
Country	:	US
Telephone Number	:	850-784-0818
Fax Number	:	850-784-1871

Provider Business Practice Location Address
First Line	:	1714 W 23RD ST STE P
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32405-2924
Country	:	US
Telephone Number	:	850-784-0818
Fax Number	:	850-784-1871

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/12/2007
Last Update Date	:	07/08/2007

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