Individual
ABDALLA ASI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
653-1 W 8TH ST, JACKSONVILLE, FL 32209-6511
(904) 244-2000
Mailing address
653-1 W 8TH ST, JACKSONVILLE, FL 32209-6511
(904) 244-2000
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN28133
FL
1223G0001X
General Practice Dentistry
30.024873
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/07/2016
Last updated
01/24/2024
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