Ghazwan Al Kubaisi
Dentist in Vero Beach, FL. Individual provider (NPI-1).
NPI number1154987915
StatusActive
Last updated in NPPESAug 19, 2021
Details
- NPI
- 1154987915
- Entity type
- Individual (NPI-1)
- Name
- Ghazwan Al Kubaisi
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 16, 2019
- Certification date
- Aug 19, 2021
- Last updated
- Aug 19, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | DN26294 | FL | Yes |
| 122300000X | Dentist | D14196 | MN |
Practice location
1960 25th Ave Ste 101Vero Beach, FL 32960-3015
Phone 561-999-9650
Mailing address
964 Lynn Rd SwHutchinson, MN 55350-3151
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