Provider Demographics
NPI:1861510794
Name:SENFT, MITCHEL A (DMD)
Entity Type:Individual
Prefix:DR
First Name:MITCHEL
Middle Name:A
Last Name:SENFT
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 1:6633 FOREST HILL BLVD
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33413-3354
Mailing Address - Country:US
Mailing Address - Phone:561-967-2001
Mailing Address - Fax:561-967-2201
Practice Address - Street 1:6633 FOREST HILL BLVD
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33413-3354
Practice Address - Country:US
Practice Address - Phone:561-967-2001
Practice Address - Fax:561-967-2201
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2009-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN00093865122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist