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General NPI Number Information
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NPI Number | 1669740650
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Entity Type | Organization
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Legal Business Name | STUART M. HIRSCH, D.M.D. P.A.
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Dates
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Enumeration Date | 12/06/2011
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Last Update Date | 01/05/2012
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Provider Practice Location Address
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Address Line | 7305 WEST SAMPLE RD SUITE 102
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-2251
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Country | US
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Telephone | 954-753-6340
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Fax | 954-753-1745
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Provider Business Mailing Address
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Address Line | 7305 W SAMPLE RD SUITE 102
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-2258
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Country | US
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Telephone | 954-753-9787
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Fax | 954-753-1745
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. STUART MILES HIRSCH
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Credential | D.M.D.
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Telephone | 954-753-9787
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 8423
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License Number State | FL
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