MEDICARE: AFFORDABLE DENTURES - FORT LAUDERDALE, P.A.

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	DN10908	FL

General Provider Information

NPI Number	:	1831332048
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AFFORDABLE DENTURES - FORT LAUDERDALE, P.A.

Provider Business Mailing Address
First Line	:	8393 PINES BLVD
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33024-6607
Country	:	US
Telephone Number	:	954-431-2944
Fax Number	:

Provider Business Practice Location Address
First Line	:	8393 PINES BLVD
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33024-6607
Country	:	US
Telephone Number	:	954-431-2944
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JEFFREY FRIEFELD
Credential	:
Telephone Number	:	954-431-2944

Provider Enumeration Date	:	04/17/2009
Last Update Date	:	04/17/2009

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