Individual
DIMA GHANDOUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
4077 TAMIAMI TRL N, SUITE D203, NAPLES, FL 34103-8737
(239) 658-3721
(239) 263-1932
Mailing address
1454 MADISON AVE W, IMMOKALEE, FL 34142-2200
(239) 658-3721
(239) 263-1932
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN18045
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
017212900
—
FL
Enumeration date
08/17/2007
Last updated
08/09/2016
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