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General NPI Number Information
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NPI Number | 1366776999
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Entity Type | Individual
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Provider Name | DAVID H KORNBLUTH DMD
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Gender | Male
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Dates
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Enumeration Date | 09/29/2009
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Last Update Date | 09/29/2009
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Provider Practice Location Address
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Address Line | 19080 NE 29TH AVE
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City | AVENTURA
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State | FL
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Zip | 33180-2805
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Country | US
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Telephone | 305-944-1946
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Fax | 305-931-4051
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Provider Business Mailing Address
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Address Line | 3660 N 45TH AVE
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City | HOLLYWOOD
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State | FL
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Zip | 33021-2449
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Country | US
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Telephone | 954-966-3060
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 5426
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License Number State | FL
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