Provider Demographics
NPI:1962247718
Name:HOEHN-SARIC, KELSEY (DMD)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:
Last Name:HOEHN-SARIC
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5800 REESE RD APT 216
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33314-1285
Mailing Address - Country:US
Mailing Address - Phone:910-690-9851
Mailing Address - Fax:
Practice Address - Street 1:1 SW 129TH AVE STE 302
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33027-1717
Practice Address - Country:US
Practice Address - Phone:954-437-4443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-25
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN291851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice