MEDICARE: DENTALAND PA

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	122300000X	Dentist	DN5487	FL

General Provider Information

NPI Number	:	1275795825
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DENTALAND PA

Provider Business Mailing Address
First Line	:	3230 W COMMERCIAL BLVD
Second Line	:	SUITE 190
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33309-3429
Country	:	US
Telephone Number	:	954-719-4420
Fax Number	:	954-678-9539

Provider Business Practice Location Address
First Line	:	2960 AVENTURA BLVD
Second Line	:
City	:	AVENTURA
State	:	FL
Zip	:	33180-3103
Country	:	US
Telephone Number	:	305-935-1400
Fax Number	:	305-932-6464

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JEFFREY FEINGOLD
Credential	:	DDS
Telephone Number	:	954-719-4420

Provider Enumeration Date	:	06/25/2008
Last Update Date	:	06/25/2008

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Directions to “DENTALAND PA ” Practice Location

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