Individual
FADI KHALED AEADAH MDANAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1912 HAYES AVE, SANDUSKY, OH 44870-4736
(419) 219-4745
Mailing address
277 MAIN ST APT 338, WESTLAKE, OH 44145-8178
(305) 440-6604
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DN26284
FL
1223D0001X
Public Health Dentistry
Primary
30.026643
OH
Other
Enumeration date
08/17/2021
Last updated
12/14/2021
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