MEDICARE: DR. JASON PHILIP HIRSCH DMD MPH

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	1223P0221X	Pediatric Dentistry	DN 15983	FL

General Provider Information

NPI Number	:	1548489545
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JASON PHILIP HIRSCH DMD MPH

Provider Business Mailing Address
First Line	:	8992 LITTLE FALLS WAY
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33446-9592
Country	:	US
Telephone Number	:	954-242-6181
Fax Number	:

Provider Business Practice Location Address
First Line	:	685 ROYAL PALM BEACH BLVD
Second Line	:
City	:	ROYAL PALM BEACH
State	:	FL
Zip	:	33411-7642
Country	:	US
Telephone Number	:	561-795-7959
Fax Number	:

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

Provider Enumeration Date	:	04/25/2007
Last Update Date	:	06/04/2015

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