MEDICARE: DR. MITCHEL A SENFT DMD

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	DN00093865	FL

General Provider Information

NPI Number	:	1861510794
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MITCHEL A SENFT DMD

Provider Business Mailing Address
First Line	:	6633 FOREST HILL BLVD
Second Line	:
City	:	GREENACRES
State	:	FL
Zip	:	33413-3354
Country	:	US
Telephone Number	:	561-967-2001
Fax Number	:	561-967-2201

Provider Business Practice Location Address
First Line	:	6633 FOREST HILL BLVD
Second Line	:
City	:	GREENACRES
State	:	FL
Zip	:	33413-3354
Country	:	US
Telephone Number	:	561-967-2001
Fax Number	:	561-967-2201

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

Provider Enumeration Date	:	03/27/2007
Last Update Date	:	09/01/2009

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