| New Image Dentistry Of Palm Bay Road, Inc | |
|
1764 Palm Bay Rd Ne Palm Bay FL 32905-2904 | |
| (321) 725-5512 | |
| (321) 725-5592 |
| Full Name | New Image Dentistry Of Palm Bay Road, Inc |
|---|---|
| Speciality | Dentist |
| Location | 1764 Palm Bay Rd Ne, Palm Bay, Florida |
| Authorized Official Name and Position | Mohammed Mujeeb (OWNER/DENTIST) |
| Authorized Official Contact | 3215360157 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| New Image Dentistry Of Palm Bay Road, Inc 1764 Palm Bay Rd Ne Palm Bay FL 32905-2904 Ph: (321) 725-5512 | New Image Dentistry Of Palm Bay Road, Inc 1764 Palm Bay Rd Ne Palm Bay FL 32905-2904 Ph: (321) 725-5512 |
| NPI Number | 1952847774 |
|---|---|
| Provider Enumeration Date | 01/18/2017 |
| Last Update Date | 01/18/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952847774 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DN21355 (Florida) | Primary |
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