Provider Demographics
NPI:1275765547
Name:MOHR, ERIC EARL (DMD)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:EARL
Last Name:MOHR
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 1:2757 NE 37TH DR
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-6326
Mailing Address - Country:US
Mailing Address - Phone:954-882-8421
Mailing Address - Fax:
Practice Address - Street 1:1901 N FEDERAL HWY UNIT 215
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33062-1000
Practice Address - Country:US
Practice Address - Phone:954-785-1102
Practice Address - Fax:954-785-1344
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-19
Last Update Date:2016-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN15689122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist