Provider Demographics
NPI:1912081449
Name:OSTROFF, LEONARD STEVEN (DMD)
Entity Type:Individual
Prefix:
First Name:LEONARD
Middle Name:STEVEN
Last Name:OSTROFF
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 1:8580 N LAKE DASHA DR
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-3119
Mailing Address - Country:US
Mailing Address - Phone:954-472-6724
Mailing Address - Fax:
Practice Address - Street 1:17301 NW 27TH AVE
Practice Address - Street 2:
Practice Address - City:OPA LOCKA
Practice Address - State:FL
Practice Address - Zip Code:33056-4001
Practice Address - Country:US
Practice Address - Phone:305-624-1371
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN69391223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics