=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124250683
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ARTHUR L. KAMINSKY D.D.S.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/18/2009
-----------------------------------------------------
Last Update Date | 08/18/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 997 S ROCK ISLAND RD
-----------------------------------------------------
City | NORTH LAUDERDALE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33068-2313
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-722-1522
-----------------------------------------------------
Fax | 954-721-0625
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 997 S ROCK ISLAND RD
-----------------------------------------------------
City | NORTH LAUDERDALE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33068-2313
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-722-1522
-----------------------------------------------------
Fax | 954-721-0625
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. ARTHUR LEONARD KAMINSKY
-----------------------------------------------------
Credential | D.D.S.
-----------------------------------------------------
Telephone | 954-722-1522
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number | 6853
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------