Provider Demographics
NPI:1629083340
Name:NAMOFF, ANTHONY V (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:V
Last Name:NAMOFF
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8024 SW 199TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33189-2128
Mailing Address - Country:US
Mailing Address - Phone:305-253-4381
Mailing Address - Fax:
Practice Address - Street 1:9299 SW 152ND ST
Practice Address - Street 2:SUITE 204
Practice Address - City:VILLAGE OF PALMETTO BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-1775
Practice Address - Country:US
Practice Address - Phone:305-251-0620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLFL DN 60821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice