Individual
KASIM MANZUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3590 BAYSIDE LAKES BLVD SE, PALM BAY, FL 32909-6866
(321) 984-0044
Mailing address
3590 BAYSIDE LAKES BLVD SE, PALM BAY, FL 32909-6866
(321) 984-0044
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN20767
FL
Other
Enumeration date
07/09/2014
Last updated
07/09/2014
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