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Organization
MAX FORNI DMD P.A.
Active
Organization
MAX FORNI DMD P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAX FORNI DMD (PRESIDENT)
(863) 676-6021
Entity
Organization
Contact information
Practice address
701 STATE ROAD 60 E, LAKE WALES, FL 33853-4240
(863) 676-6021
(863) 679-6406
Mailing address
701 STATE ROAD 60 E, LAKE WALES, FL 33853-4240
(863) 676-6021
(863) 679-6406
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN15652
FL
1223G0001X
General Practice Dentistry
DN18156
FL
Other
Enumeration date
07/09/2009
Last updated
07/09/2009
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