Individual
DOUGLAS FUJAWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Contact information
Practice address
3123 W 23RD ST, PANAMA CITY, FL 32405-1828
(850) 481-1969
Mailing address
3123 W 23RD ST, PANAMA CITY, FL 32405-1828
(850) 481-1969
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
2901021229
MI
1223P0221X
Pediatric Dentistry
Primary
DN23156
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
023778300
—
FL
Enumeration date
09/23/2014
Last updated
04/19/2018
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