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Individual

DR. ARYEH LEIB FORMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.M.D.

Contact information

Practice address
1505 NW 167TH ST STE 100, MIAMI, FL 33169-5133
(305) 625-5400
(305) 625-8110
Mailing address
1505 NW 167TH ST STE 100, MIAMI, FL 33169-5133
(847) 420-1293

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
22DI02862100
NJ
1223G0001X
General Practice Dentistry
Primary
DN25949
FL

Other

Enumeration date
04/18/2021
Last updated
01/07/2024
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