Individual
BASIL HAMMOUDEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
4307 E COLONIAL DR, ORLANDO, FL 32803-5217
(407) 514-0400
(407) 206-3573
Mailing address
6452 VINELAND RD UNIT 301, ORLANDO, FL 32819-7875
(407) 929-9495
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
17461
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001974700
—
FL
Enumeration date
04/19/2006
Last updated
04/24/2013
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