Individual
MOUADA ABDELLATIF ABDELAAL FADUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
4090 WESTOWN PKWY STE B1, WEST DES MOINES, IA 50266-6760
(515) 267-0737
(515) 267-1480
Mailing address
542 S 160TH ST, OMAHA, NE 68118-2120
(252) 481-1530
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DDS-10267
IA
1223G0001X
General Practice Dentistry
DDS-10267
IA
1223P0221X
Pediatric Dentistry
Primary
DDS-10267
IA
Other
Enumeration date
05/21/2022
Last updated
09/13/2024
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