Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | DN11961 | FL |
NPI | 1144637133 |
---|---|
Provider Name | Sorin Dimitriu |
First Address | Deerfield Beach, FL 33441-4355 |
Second Address | Deerfield Beach, FL 33441-4355 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2014 |
Last Update Date | 22/07/2014 |