Provider Demographics
NPI:1639423080
Name:DENTIST ON CALL, LLC
Entity Type:Organization
Organization Name:DENTIST ON CALL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ZIYAD
Authorized Official - Middle Name:
Authorized Official - Last Name:MAALI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:407-403-0260
Mailing Address - Street 1:7932 W SAND LAKE RD
Mailing Address - Street 2:SUITE #301
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-7263
Mailing Address - Country:US
Mailing Address - Phone:407-403-0260
Mailing Address - Fax:
Practice Address - Street 1:7932 W SAND LAKE RD
Practice Address - Street 2:SUITE #301
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-7263
Practice Address - Country:US
Practice Address - Phone:407-403-0260
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-07
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN160191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty