| Kawveh Nofallah Dmd Pa | |
|
3624 Harden Blvd Lakeland FL 33803-5938 | |
| (863) 648-5338 | |
| (863) 648-5890 |
| Full Name | Kawveh Nofallah Dmd Pa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3624 Harden Blvd, Lakeland, Florida |
| Authorized Official Name and Position | Kawveh Nofallah (OWNER-DENTIST) |
| Authorized Official Contact | 8636485338 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kawveh Nofallah Dmd Pa 3624 Harden Blvd Lakeland FL 33803-5938 Ph: (863) 648-5338 | Kawveh Nofallah Dmd Pa 3624 Harden Blvd Lakeland FL 33803-5938 Ph: (863) 648-5338 |
| NPI Number | 1851479265 |
|---|---|
| Provider Enumeration Date | 11/02/2006 |
| Last Update Date | 09/18/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851479265 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DN 17075 (Florida) | Primary |
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