MEDICARE: DR. AMR A ABOUZEID BDS, MSD

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	S222	MN

General Provider Information

NPI Number	:	1508697483
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMR A ABOUZEID BDS, MSD

Provider Business Mailing Address
First Line	:	3959 2ND ST S STE 207208
Second Line	:
City	:	SAINT CLOUD
State	:	MN
Zip	:	56301-3876
Country	:	US
Telephone Number	:	320-204-5291
Fax Number	:

Provider Business Practice Location Address
First Line	:	3959 2ND ST S STE 207208
Second Line	:
City	:	SAINT CLOUD
State	:	MN
Zip	:	56301-3876
Country	:	US
Telephone Number	:	320-204-5291
Fax Number	:

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

Provider Enumeration Date	:	08/12/2024
Last Update Date	:	08/12/2024

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