Provider Demographics
NPI:1215029509
Name:EFROM, LEONARD DAVID (DDS PA)
Entity Type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:DAVID
Last Name:EFROM
Suffix:
Gender:M
Credentials:DDS PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11645 BISCAYNE BOULEVARD
Mailing Address - Street 2:SUITE 407
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33181
Mailing Address - Country:US
Mailing Address - Phone:305-891-2621
Mailing Address - Fax:305-891-7279
Practice Address - Street 1:11645 BISCAYNE BOULEVARD
Practice Address - Street 2:SUITE 407
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181
Practice Address - Country:US
Practice Address - Phone:305-891-2621
Practice Address - Fax:305-891-7279
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN4291122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3136OtherCOMP BENEFITS