MEDICARE: MICHELLE KUZNIA D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	2901021907	MI
2	1223G0001X	General Practice Dentistry	2901021907	MI
3	1223G0001X	General Practice Dentistry	00203903	CO
4	1223G0001X	General Practice Dentistry	DN26644	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00203903	OTHER	CO	COLORADO DENTIST LICENSE

General Provider Information

NPI Number	:	1699220285
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE KUZNIA D.D.S.

Provider Business Mailing Address
First Line	:	551 N FEDERAL HWY STE 900
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33301-2559
Country	:	US
Telephone Number	:	313-247-5406
Fax Number	:

Provider Business Practice Location Address
First Line	:	551 N FEDERAL HWY STE 900
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33301-2559
Country	:	US
Telephone Number	:	313-247-5406
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2016
Last Update Date	:	05/03/2022

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Directions to “ MICHELLE KUZNIA D.D.S.” Practice Location

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