Individual
JEROME IRA BISTRITZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
6130 W ATLANTIC BLVD, MARGATE, FL 33063-5123
(954) 973-0990
(954) 973-1794
Mailing address
4544 N JEFFERSON AVE, MIAMI BEACH, FL 33140-2938
(786) 271-9522
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
9549
FL
Other
Enumeration date
11/03/2006
Last updated
11/03/2020
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