MEDICARE: DR. KARL J FOOSE DDS 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	DN 2313	FL

General Provider Information

NPI Number	:	1508965302
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. KARL J FOOSE DDS PA

Provider Business Mailing Address
First Line	:	4100 SOUTH DIXIE HIGHWAY
Second Line	:	SUITE A
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33405-2647
Country	:	US
Telephone Number	:	561-655-3404
Fax Number	:

Provider Business Practice Location Address
First Line	:	4100 SOUTH DIXIE HIGHWAY
Second Line	:	SUITE A
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33405-2647
Country	:	US
Telephone Number	:	561-655-3404
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. KARL JOSEF FOOSE
Credential	:	DDS
Telephone Number	:	561-655-3404

Provider Enumeration Date	:	09/21/2006
Last Update Date	:	08/22/2020

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