Individual
HAIDER ALDALLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
540 STATE ROAD 13 N STE 101, FRUIT COVE, FL 32259-3873
(904) 217-4019
Mailing address
54 BOULDER LN, ST JOHNS, FL 32259-3296
(832) 829-3633
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN28119
FL
Other
Enumeration date
06/15/2023
Last updated
07/29/2024
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