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General NPI Number Information
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NPI Number | 1902940315
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Entity Type | Organization
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Legal Business Name | LISA M FELDMAN DMD PA
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Dates
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Enumeration Date | 02/18/2007
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Last Update Date | 04/22/2015
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Provider Practice Location Address
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Address Line | 9804 S MILITARY TRL SUITE E-3
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City | BOYNTON BEACH
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State | FL
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Zip | 33436-3208
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Country | US
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Telephone | 561-737-3633
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Fax | 561-737-5194
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Provider Business Mailing Address
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Address Line | 9804 S MILITARY TRL SUITE E-3
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City | BOYNTON BEACH
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State | FL
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Zip | 33436-3208
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Country | US
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Telephone | 561-737-3633
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Fax | 561-737-5194
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Authorized Official
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Title or Position | PRESIDENT
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Name | LISA M FELDMAN
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Credential | DMD
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Telephone | 561-737-3633
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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 | DN11970
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License Number State | FL
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