MEDICARE: AFFORDABLE DENTURES & IMPLANTS - WINTER HAVEN II, P.A.

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	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1649061466
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AFFORDABLE DENTURES & IMPLANTS - WINTER HAVEN II, P.A.

Provider Business Mailing Address
First Line	:	426 CITI CTR ST BAY R-10
Second Line	:
City	:	WINTER HAVEN
State	:	FL
Zip	:	33880-3425
Country	:	US
Telephone Number	:	863-291-8161
Fax Number	:

Provider Business Practice Location Address
First Line	:	426 CITI CTR ST BAY R-10
Second Line	:
City	:	WINTER HAVEN
State	:	FL
Zip	:	33880-3425
Country	:	US
Telephone Number	:	863-291-8161
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	AMEL HASSAN
Credential	:	DDS
Telephone Number	:	863-291-8161

Provider Enumeration Date	:	05/13/2025
Last Update Date	:	05/13/2025

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