Provider Demographics
NPI:1508873290
Name:SHAPIRO, SANFORD MARK (DMD)
Entity Type:Individual
Prefix:
First Name:SANFORD
Middle Name:MARK
Last Name:SHAPIRO
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 1:13550 N KENDALL DR
Mailing Address - Street 2:SUITE 170
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-1543
Mailing Address - Country:US
Mailing Address - Phone:305-387-3002
Mailing Address - Fax:305-388-5900
Practice Address - Street 1:13550 N KENDALL DR
Practice Address - Street 2:SUITE 170
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-1543
Practice Address - Country:US
Practice Address - Phone:305-387-3002
Practice Address - Fax:305-388-5900
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLD8069122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist