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Individual

ATM N AMIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
BDS

Contact information

Practice address
1890 PALM BAY RD NE, SUITE 2, PALM BAY, FL 32905-3071
(321) 724-5100
(321) 724-5139
Mailing address
1890 PALM BAY RD NE, SUITE 2, PALM BAY, FL 32905-3071
(321) 724-5100
(321) 724-5139

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN10430
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
077777300
FL
Enumeration date
08/26/2006
Last updated
11/03/2016
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