SHADY ASHAMALLA

TITUSVILLE, FL
NPI1427428374
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy122300000X Dentist
(Licence: FL  24595)
Additional Taxonomies122300000X Dentist
(Licence: NC  10238)
Enumeration Date2015-10-05
Last Update Date2021-08-08
Business Address
SHADY ASHAMALLA DDS
3245 GARDEN ST
TITUSVILLE, FL 32796-3004
Phone number: 321-269-2700
Mailing Address
SHADY ASHAMALLA DDS
4951 S WASHINGTON AVE # 32780
TITUSVILLE, FL 32780-7319
Phone number: 602-481-0153
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