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General NPI Number Information
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NPI Number | 1487094934
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Entity Type | Organization
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Legal Business Name | AMERICAN DENTAL OF FL-FORT LAUDERDALE
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Dates
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Enumeration Date | 06/28/2013
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Last Update Date | 06/28/2013
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Provider Practice Location Address
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Address Line | 2740 E COMMERCIAL BLVD
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City | FORT LAUDERDALE
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State | FL
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Zip | 33308-4113
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Country | US
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Telephone | 954-938-2447
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Fax | 954-938-3527
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Provider Business Mailing Address
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Address Line | 2740 E COMMERCIAL BLVD
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City | FORT LAUDERDALE
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State | FL
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Zip | 33308-4113
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Country | US
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Telephone | 954-938-2447
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Fax | 954-938-3527
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Authorized Official
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Title or Position | CO-OWNER
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Name | DR. JAMES KERNS JR.
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Credential | DMD
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Telephone | 954-938-2447
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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 | DN17150
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License Number State | FL
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