Provider Demographics
NPI:1124463195
Name:KRICHMAR, JEFFREY (DMD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:
Last Name:KRICHMAR
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 1:2801 N UNIVERSITY DR STE 101
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-5052
Mailing Address - Country:US
Mailing Address - Phone:954-752-7760
Mailing Address - Fax:
Practice Address - Street 1:2801 N UNIVERSITY DR STE 101
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-5052
Practice Address - Country:US
Practice Address - Phone:954-752-7760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-06
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLFLDN0012340122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist