Provider Demographics
NPI:1760645949
Name:HAMDI, AMAL (DDS)
Entity Type:Individual
Prefix:DR
First Name:AMAL
Middle Name:
Last Name:HAMDI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2175 JUDGE FRAN JAMIESON WAY APT 309
Mailing Address - Street 2:
Mailing Address - City:VIERA
Mailing Address - State:FL
Mailing Address - Zip Code:32940-6177
Mailing Address - Country:US
Mailing Address - Phone:772-696-0646
Mailing Address - Fax:
Practice Address - Street 1:696 COUNTRY CLUB DR
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:FL
Practice Address - Zip Code:32780-4977
Practice Address - Country:US
Practice Address - Phone:772-696-0646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-08
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN18389122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist