Provider Demographics
NPI:1720584709
Name:BOHORQUEZ, GERMAN E (DMD)
Entity Type:Individual
Prefix:DR
First Name:GERMAN
Middle Name:E
Last Name:BOHORQUEZ
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 1:3695 NW 1ST ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-4839
Mailing Address - Country:US
Mailing Address - Phone:305-404-9937
Mailing Address - Fax:305-404-9938
Practice Address - Street 1:3695 NW 1ST ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-4839
Practice Address - Country:US
Practice Address - Phone:305-404-9937
Practice Address - Fax:305-404-9938
Is Sole Proprietor?:No
Enumeration Date:2018-03-30
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN25136122300000X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist