Organization
FAMILY DENTAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. QAYYUM KHAMBATY (OWNER)
(727) 841-7711
Entity
Organization
Contact information
Practice address
6333 STATE ROAD 54, NEW PORT RICHEY, FL 34653-6037
(727) 841-7711
Mailing address
6333 STATE ROAD 54, NEW PORT RICHEY, FL 34653-6037
(727) 841-7711
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN10323
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
077757900
—
FL
Enumeration date
09/19/2013
Last updated
09/19/2013
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