Individual
ALAN JAMES FASANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
702 JASMINE WAY, CLEARWATER, FL 33756-4086
(727) 824-8181
Mailing address
14100 58TH ST N, CLEARWATER, FL 33760-9900
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH17852
FL
Other
Enumeration date
01/29/2024
Last updated
01/29/2024
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