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Individual

DR. JOHN TAWADROUS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
501 N ORLANDO AVE STE 233, WINTER PARK, FL 32789-2947
(407) 792-0637
Mailing address
4930 E. LAKE MARY BLVD., SANFORD, FL 32771
(407) 322-8645

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
DN22323
FL
1223P0221X
Pediatric Dentistry
Primary
DN22323
FL
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
021314900
FL
Enumeration date
09/15/2016
Last updated
08/31/2020
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