Baddour, Mary

Baddour, Mary is an individual health care provider with primary practice located at 2120 Sarno Rd , Melbourne FL 32935-3084. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Baddour, Mary can be contacted via phone (321) 241-6800.

Contact Information

Primary practice address
2120 Sarno Rd Melbourne FL 32935-3084
Fax: (321) 241-6890
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X DN22332 Florida
Dental Providers / General Practice 1223G0001X DD4616 New Mexico

Profile Details

NPI number 1730630633
LBN Legal business name Baddour, Mary
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 17th, 2016
Last updated Aug 8th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730630633 NPPES
Florida MEDICAID 109040300

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