Individual
ABDULAZIZ BANASSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BDS
Contact information
Practice address
1395 CENTER DR, GAINESVILLE, FL 32610-3006
(352) 273-6683
Mailing address
1395 CENTER DR GAINESVILLE FL 32610-3006, GAINESVILLE, FL 32610-0001
(352) 273-6683
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
DRPM1792
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DRPM1792
FLORIDA DEPARTMENT OF HEALTH
FL
Enumeration date
10/23/2018
Last updated
06/26/2020
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