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General NPI Number Information
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NPI Number | 1053413831
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Entity Type | Organization
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Legal Business Name | .SHOFNOS AND ADAMI, DDS PA
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Dates
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Enumeration Date | 09/02/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 12129 SHERIDAN ST
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City | HOLLYWOOD
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State | FL
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Zip | 33026-1400
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Country | US
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Telephone | 954-433-1888
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Fax | 954-438-3560
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Provider Business Mailing Address
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Address Line | 12129 SHERIDAN ST
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City | HOLLYWOOD
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State | FL
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Zip | 33026-1400
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Country | US
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Telephone | 954-433-1888
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Fax | 954-438-3560
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Authorized Official
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Title or Position | PRESIDNET
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Name | DR. CHARLES IRVING SHOFNOS
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Credential | D.D.S.
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Telephone | 954-433-1888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN6140
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License Number State | FL
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