Individual
DR. OMAR FETOUH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
900 N BLUE MOUND RD, SUITE 128, SAGINAW, TX 76131-4810
(716) 348-9855
Mailing address
900 N BLUE MOUND RD, SUITE 128, SAGINAW, TX 76131-4810
(716) 348-9855
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
24314
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1467674309
—
TX
05
—
1568871523
—
TX
Enumeration date
11/17/2008
Last updated
10/29/2015
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