Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 3772 | FL |
NPI | 1013022342 |
---|---|
Provider Name | Joel Melvin Hauptman |
First Address | Davie, FL 33328-2018 |
Second Address | Davie, FL 33328-2018 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2006 |
Last Update Date | 08/07/2007 |