Provider Demographics
NPI:1871231548
Name:FIFFE & MCINTOSH DENTAL CARE, PLLC
Entity Type:Organization
Organization Name:FIFFE & MCINTOSH DENTAL CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELISEO
Authorized Official - Middle Name:
Authorized Official - Last Name:FIFFE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:786-314-2589
Mailing Address - Street 1:8188 S JOG RD STE 104
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33472-2952
Mailing Address - Country:US
Mailing Address - Phone:786-314-2589
Mailing Address - Fax:
Practice Address - Street 1:8188 S JOG RD STE 104
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33472-2952
Practice Address - Country:US
Practice Address - Phone:786-314-2589
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-23
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental