Individual
FADY SHAABAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1900 S FERDON BLVD STE 170, CRESTVIEW, FL 32536-8510
(850) 331-3392
Mailing address
4320 COMMONS DR W UNIT 1312, DESTIN, FL 32541-8646
(224) 801-9108
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN25643
FL
Other
Enumeration date
01/27/2021
Last updated
07/29/2024
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