Provider Demographics
NPI:1902230352
Name:WINTER SPRINGS DENTAL EXCELLENCE
Entity Type:Organization
Organization Name:WINTER SPRINGS DENTAL EXCELLENCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:FADI
Authorized Official - Middle Name:
Authorized Official - Last Name:AOUN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:407-529-8482
Mailing Address - Street 1:1008 WILLA SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-5205
Mailing Address - Country:US
Mailing Address - Phone:407-696-1235
Mailing Address - Fax:407-696-2839
Practice Address - Street 1:1008 WILLA SPRINGS DR
Practice Address - Street 2:
Practice Address - City:WINTER SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32708-5205
Practice Address - Country:US
Practice Address - Phone:407-696-1235
Practice Address - Fax:407-696-2839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-21
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN159201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty