Provider Demographics
NPI:1104920479
Name:ADLER, ANDREW JONATHAN (DMD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:JONATHAN
Last Name:ADLER
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 1:3901 S OCEAN DR
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33019-3016
Mailing Address - Country:US
Mailing Address - Phone:954-457-7637
Mailing Address - Fax:954-454-2980
Practice Address - Street 1:3901 S OCEAN DR
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33019-3016
Practice Address - Country:US
Practice Address - Phone:954-457-7637
Practice Address - Fax:954-454-2980
Is Sole Proprietor?:No
Enumeration Date:2006-09-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN0013584122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist