Provider Demographics
NPI:1912517111
Name:BD DENTAL LLC
Entity Type:Organization
Organization Name:BD DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FADI
Authorized Official - Middle Name:R
Authorized Official - Last Name:AOUN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:407-529-8482
Mailing Address - Street 1:3639 KIESSEL RD
Mailing Address - Street 2:
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32163-2909
Mailing Address - Country:US
Mailing Address - Phone:352-350-7445
Mailing Address - Fax:352-350-7726
Practice Address - Street 1:3639 KIESSEL RD
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32163-2909
Practice Address - Country:US
Practice Address - Phone:352-350-7445
Practice Address - Fax:352-350-7726
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-03
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental