Individual
ENEA BIFSHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3727 N GOLDENROD RD STE 108, WINTER PARK, FL 32792-8611
(407) 671-0001
Mailing address
3727 N GOLDENROD RD STE 108, WINTER PARK, FL 32792-8611
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN19721
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005831600
—
FL
Enumeration date
06/12/2012
Last updated
01/08/2015
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