Provider Demographics
NPI:1912726274
Name:FF DENTAL PA
Entity type:Organization
Organization Name:FF DENTAL PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:FERNANDEZ-FEOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-477-7655
Mailing Address - Street 1:7902 NW 36TH ST STE 212
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33166-6663
Mailing Address - Country:US
Mailing Address - Phone:305-477-7655
Mailing Address - Fax:305-477-7654
Practice Address - Street 1:7902 NW 36TH ST STE 212
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-6663
Practice Address - Country:US
Practice Address - Phone:305-477-7655
Practice Address - Fax:305-477-7654
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-04
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty