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3 Sw 129th Ave Ste 205 Pembroke Pines FL 33027-1775 | |
| (954) 438-4282 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - Endodontics |
| Location | 3 Sw 129th Ave, Pembroke Pines, Florida |
| Authorized Official Name and Position | Edward Ronald Kirsh (OWNER/PARTNER) |
| Authorized Official Contact | 9544384282 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3 Sw 129th Ave Ste 205 Pembroke Pines FL 33027-1775 Ph: (954) 438-4282 | 3 Sw 129th Ave Ste 205 Pembroke Pines FL 33027-1775 Ph: (954) 438-4282 |
| NPI Number | 1427500610 |
|---|---|
| Provider Enumeration Date | 11/04/2016 |
| Last Update Date | 11/04/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427500610 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | DN0013302 (Florida) | Primary |
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