Organization
DR. FATAH, D.D.S.,P.C.
Active
Other names
Aspen Dental
Organization subpart
No
Provider details
NPI number
Authorized official
WALID FATAH (OWNER)
(515) 509-2800
Entity
Organization
Contact information
Practice address
806 S DUFF AVE STE 104, AMES, IA 50010-6823
(515) 509-2800
(515) 232-0419
Mailing address
PO BOX 3189, SYRACUSE, NY 13220-3189
(315) 454-6000
(315) 410-5531
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
08969
IA
Other
Enumeration date
05/11/2017
Last updated
05/11/2017
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