Provider Demographics
NPI:1881985042
Name:EPSTEIN, MITCHELL ROBERT (DMD)
Entity type:Individual
Prefix:DR
First Name:MITCHELL
Middle Name:ROBERT
Last Name:EPSTEIN
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 1:8430 W BROWARD BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-2700
Mailing Address - Country:US
Mailing Address - Phone:954-474-3330
Mailing Address - Fax:954-236-3025
Practice Address - Street 1:8430 W BROWARD BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-2700
Practice Address - Country:US
Practice Address - Phone:954-474-3330
Practice Address - Fax:954-236-3025
Is Sole Proprietor?:No
Enumeration Date:2011-04-22
Last Update Date:2011-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN10484122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist