Provider Demographics
NPI:1902264385
Name:BADR, FATMA (BDS)
Entity Type:Individual
Prefix:DR
First Name:FATMA
Middle Name:
Last Name:BADR
Suffix:
Gender:F
Credentials:BDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5400 NW 39TH AVE APT H44
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-6949
Mailing Address - Country:US
Mailing Address - Phone:352-213-1226
Mailing Address - Fax:
Practice Address - Street 1:5400 NW 39TH AVE APT H44
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-6949
Practice Address - Country:US
Practice Address - Phone:352-213-1226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-01
Last Update Date:2016-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDRP12431223X0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0008XDental ProvidersDentistOral and Maxillofacial Radiology