Provider Demographics
NPI:1710902929
Name:KNOLL, FREDERICK ERNEST (DDS)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:ERNEST
Last Name:KNOLL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:951 NE 167TH ST
Mailing Address - Street 2:SUITE 208
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33162-3711
Mailing Address - Country:US
Mailing Address - Phone:305-651-0139
Mailing Address - Fax:305-651-0152
Practice Address - Street 1:951 NE 167TH ST
Practice Address - Street 2:SUITE 208
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-3711
Practice Address - Country:US
Practice Address - Phone:305-651-0139
Practice Address - Fax:305-651-0152
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN58761223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics