Provider Demographics
NPI:1154401339
Name:ALAFAYA WOODS COSMETIC AND FAMILY DENTISTRY
Entity type:Organization
Organization Name:ALAFAYA WOODS COSMETIC AND FAMILY DENTISTRY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:NADJI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:407-592-9406
Mailing Address - Street 1:83 ALAFAYA WOODS BLVD
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-6235
Mailing Address - Country:US
Mailing Address - Phone:407-977-9888
Mailing Address - Fax:407-977-7163
Practice Address - Street 1:83 ALAFAYA WOODS BLVD
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-6235
Practice Address - Country:US
Practice Address - Phone:407-977-9888
Practice Address - Fax:407-977-7163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL14347122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty