Organization
ALKHADRA DDS, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ENAS ALKHADRA DDS (OWNER)
(561) 212-0715
Entity
Organization
Contact information
Practice address
4800 NE 20TH TER STE 301, FORT LAUDERDALE, FL 33308-4510
(954) 727-9865
(954) 727-9904
Mailing address
4800 NE 20TH TER STE 301, FORT LAUDERDALE, FL 33308-4510
(954) 727-9865
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DN16650
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
075773000
—
FL
Enumeration date
10/16/2009
Last updated
06/29/2010
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