Individual
ADAM AGHYAD TARBOUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1340 BLANDING BLVD STE 108, ORANGE PARK, FL 32065-8052
(904) 639-6924
Mailing address
1750 TIVERTON RD UNIT 27, BLOOMFIELD HILLS, MI 48304-2368
(248) 954-7168
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN26982
FL
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
05/24/2022
Last updated
07/03/2022
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