Provider Demographics
NPI:1477753739
Name:DRS PASS & FRYDMAN PA
Entity Type:Organization
Organization Name:DRS PASS & FRYDMAN PA
Other - Org Name:SOUTH FLORIDA DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:A
Authorized Official - Last Name:PASS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:954-966-6410
Mailing Address - Street 1:4030 SHERIDAN STREET
Mailing Address - Street 2:SUITE B
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021
Mailing Address - Country:US
Mailing Address - Phone:954-966-6410
Mailing Address - Fax:954-966-2094
Practice Address - Street 1:4030 SHERIDAN STREET
Practice Address - Street 2:SUITE B
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021
Practice Address - Country:US
Practice Address - Phone:954-966-6410
Practice Address - Fax:954-966-2094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-24
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental