Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | DN17547 | FL |
NPI | 1063629228 |
---|---|
Provider Name | Dr. Khaled Daoud Hamdallah |
First Address | Apopka, FL 32703-5733 |
Second Address | Apopka, FL 32703-5733 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2007 |
Last Update Date | 18/07/2016 |