Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 1855123 | MA |
Y | 1223P0300X | Periodontist | DN18669 | FL |
NPI | 1023248408 |
---|---|
Provider Name | Dr. Joseph Emanuel Pechter |
First Address | Fort Lauderdale, FL 33312-6557 |
Second Address | Fort Lauderdale, FL 33312-6557 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2009 |
Last Update Date | 12/08/2019 |