Individual
ENAS AL-KHADRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
4800 NE 20TH TER STE 301, FORT LAUDERDALE, FL 33308-4510
(954) 727-9865
(954) 727-9940
Mailing address
4800 NE 20TH TER STE 301, FORT LAUDERDALE, FL 33308-4510
(954) 727-9865
(954) 727-9940
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DN16650
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
075773000
—
FL
Enumeration date
08/04/2006
Last updated
06/29/2010
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