Individual
JOHN FIFE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
660 E EAU GALLIE BLVD, INDIAN HARBOUR BEACH, FL 32937-4256
(321) 777-7474
Mailing address
1728 HUBBARD DR, ROCKLEDGE, FL 32955-3021
(018) 887-9058
(775) 888-4904
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN28717
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DN28717
FLORIDA STATE DENTAL LICENSE
FL
Enumeration date
09/27/2019
Last updated
12/14/2023
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