Provider Demographics
NPI:1528335452
Name:RICHARD A MUFSON, DDS, PA
Entity type:Organization
Organization Name:RICHARD A MUFSON, DDS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:MUFSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:305-935-7501
Mailing Address - Street 1:20480 W DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1128
Mailing Address - Country:US
Mailing Address - Phone:305-935-7501
Mailing Address - Fax:
Practice Address - Street 1:20480 W DIXIE HWY
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33180-1128
Practice Address - Country:US
Practice Address - Phone:305-935-7501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-21
Last Update Date:2011-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN0009682261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental