Provider Demographics
NPI:1659736726
Name:AC ORTHO PLLC
Entity Type:Organization
Organization Name:AC ORTHO PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:FETNER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:305-558-3384
Mailing Address - Street 1:4410 W 16TH AVE STE 47
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-7193
Mailing Address - Country:US
Mailing Address - Phone:305-558-3384
Mailing Address - Fax:305-828-5726
Practice Address - Street 1:4410 W 16TH AVE
Practice Address - Street 2:SUITE 54
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-7100
Practice Address - Country:US
Practice Address - Phone:305-558-3384
Practice Address - Fax:305-828-5726
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-16
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty