| Beach Dental Specialist | |
|
4011 W Flagler St. 505 Miami FL 33134 | |
| (305) 424-2705 | |
| (305) 643-0447 |
| Full Name | Beach Dental Specialist |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 4011 W Flagler St., Miami, Florida |
| Authorized Official Name and Position | Edy Augusto Guerra (PRESIDENT) |
| Authorized Official Contact | 3054242705 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Beach Dental Specialist 4011 W Flagler St. 505 Miami FL 33134 Ph: (305) 424-2705 | Beach Dental Specialist 4011 W Flagler St. 505 Miami FL 33134 Ph: (305) 424-2705 |
| NPI Number | 1477894079 |
|---|---|
| Provider Enumeration Date | 03/06/2013 |
| Last Update Date | 03/06/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477894079 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | DN18777 (Florida) | Secondary |
| 1223P0300X | Dentist - Periodontics | DN18253 (Florida) | Primary |
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