NPI 1609446632 · live from the CMS NPI Registry
5th Avenue Dental PLLC
Dentist, Periodontics in Ft Lauderdale, FL. National Provider Identifier 1609446632, active.
NPI record
| NPI | 1609446632 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dentist, Periodontics 1223P0300X |
| Practice location | 1500 N Federal Hwy Ste 280, Ft Lauderdale, FL 33304 |
| Practice phone | 561-205-5000 |
| Enumerated | June 30, 2021 |
| Last updated | June 30, 2021 |
| Authorized official | Andrew Forrest, Periodontist/Owner |
| Other names | 5th Avenue Dental |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist, Periodontics primary | 1223P0300X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.