Provider Demographics
NPI:1760733935
Name:DENTISTRY OF MIAMI
Entity Type:Organization
Organization Name:DENTISTRY OF MIAMI
Other - Org Name:RANDY FURSHMAN
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:FURSHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:305-598-2622
Mailing Address - Street 1:7800 SW 87TH AVE
Mailing Address - Street 2:A-140
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3570
Mailing Address - Country:US
Mailing Address - Phone:305-598-2622
Mailing Address - Fax:305-598-2683
Practice Address - Street 1:7800 SW 87TH AVE
Practice Address - Street 2:A-140
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3570
Practice Address - Country:US
Practice Address - Phone:305-598-2622
Practice Address - Fax:305-598-2683
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-27
Last Update Date:2012-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL88761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty