Provider Demographics
NPI:1235264136
Name:FIRIC, SINISA (DMD)
Entity Type:Individual
Prefix:DR
First Name:SINISA
Middle Name:
Last Name:FIRIC
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5461 N UNIVERSITY DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33067-4642
Mailing Address - Country:US
Mailing Address - Phone:954-755-6381
Mailing Address - Fax:
Practice Address - Street 1:5461 N UNIVERSITY DR
Practice Address - Street 2:SUITE 101
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33067-4642
Practice Address - Country:US
Practice Address - Phone:954-755-6381
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN15401122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist