Provider Demographics
NPI:1770827834
Name:ASSAF, INC
Entity Type:Organization
Organization Name:ASSAF, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WASIM
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:ASSAF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-725-9946
Mailing Address - Street 1:6050 BABCOCK ST SE STE 2
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32909-4203
Mailing Address - Country:US
Mailing Address - Phone:321-725-9946
Mailing Address - Fax:321-951-7389
Practice Address - Street 1:6050 BABCOCK ST SE STE 2
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32909-4203
Practice Address - Country:US
Practice Address - Phone:321-725-9946
Practice Address - Fax:321-951-7389
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-15
Last Update Date:2019-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty