Individual
DR. FAHAD AL-FADHLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
109 SYCAMORE RDG, MADISON, MS 39110-7333
(601) 954-4476
Mailing address
109 SYCAMORE RDG, MADISON, MS 39110-7333
(601) 898-3885
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4071-19
MS
390200000X
Student in an Organized Health Care Education/Training Program
—
MS
Other
Enumeration date
05/27/2018
Last updated
09/09/2019
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