MEDICARE: DR. JOSEF CHENCIN D.D.S.

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	1223G0001X	General Practice Dentistry	9414	FL

General Provider Information

NPI Number	:	1245393222
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEF CHENCIN D.D.S.

Provider Business Mailing Address
First Line	:	3015 BAYVIEW DR
Second Line	:	SUITE D
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33306-1710
Country	:	US
Telephone Number	:	954-561-4730
Fax Number	:	954-561-5975

Provider Business Practice Location Address
First Line	:	3015 BAYVIEW DR
Second Line	:	SUITE D
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33306-1710
Country	:	US
Telephone Number	:	954-561-4730
Fax Number	:	954-561-5975

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

Provider Enumeration Date	:	12/19/2006
Last Update Date	:	10/12/2011

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