MEDICARE: DR. MICHAEL FLORMAN DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	51399	CA

General Provider Information

NPI Number	:	1124093760
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL FLORMAN DDS

Provider Business Mailing Address
First Line	:	2901 WILSHIRE BLVD
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90403-4907
Country	:	US
Telephone Number	:	310-393-9339
Fax Number	:	310-496-2039

Provider Business Practice Location Address
First Line	:	2901 WILSHIRE BLVD
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90403-4901
Country	:	US
Telephone Number	:	310-393-9339
Fax Number	:	310-496-2039

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/17/2006
Last Update Date	:	07/08/2007

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