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General NPI Number Information
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NPI Number | 1538547120
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Entity Type | Organization
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Legal Business Name | HIRSCH DENTISTRY
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Dates
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Enumeration Date | 05/14/2015
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Last Update Date | 05/14/2015
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Provider Practice Location Address
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Address Line | 7000 W PALMETTO PARK RD
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City | BOCA RATON
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State | FL
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Zip | 33433-3424
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Country | US
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Telephone | 561-361-5665
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Fax |
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Provider Business Mailing Address
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Address Line | 8992 LITTLE FALLS WAY
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City | DELRAY BEACH
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State | FL
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Zip | 33446-9592
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JASON HIRSCH
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Credential | DMD MPH
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Telephone | 954-242-6181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 15983
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License Number State | FL
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