Provider Demographics
NPI:1780725739
Name:HONORE, FLORIAN (DDS)
Entity type:Individual
Prefix:DR
First Name:FLORIAN
Middle Name:
Last Name:HONORE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 CAROLINE AVE
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-1206
Mailing Address - Country:US
Mailing Address - Phone:516-872-1609
Mailing Address - Fax:718-284-4288
Practice Address - Street 1:338 LINDEN BLVD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-2708
Practice Address - Country:US
Practice Address - Phone:718-693-9090
Practice Address - Fax:718-284-4288
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0390971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00890868Medicaid