| Gerald W. Bird, D.m.d., P.a. | |
|
96 Willard St Suite 105 Cocoa FL 32922-8008 | |
| (321) 631-7000 | |
| (321) 631-5135 |
| Full Name | Gerald W. Bird, D.m.d., P.a. |
|---|---|
| Speciality | Dentist |
| Location | 96 Willard St, Cocoa, Florida |
| Authorized Official Name and Position | Gerald W. Bird (PRESIDENT) |
| Authorized Official Contact | 3216317000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gerald W. Bird, D.m.d., P.a. 96 Willard St Suite 105 Cocoa FL 32922-8008 Ph: (321) 631-7000 | Gerald W. Bird, D.m.d., P.a. 96 Willard St Suite 105 Cocoa FL 32922-8008 Ph: (321) 631-7000 |
| NPI Number | 1578793675 |
|---|---|
| Provider Enumeration Date | 07/23/2009 |
| Last Update Date | 07/23/2009 |
| Medicare PECOS PAC ID | 6800931874 |
|---|---|
| Medicare Enrollment ID | O20100302000186 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578793675 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 10251 (Florida) | Primary |
| Provider Name | Gerald W Bird |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1013067859 PECOS PAC ID: 4880739853 Enrollment ID: I20100302000213 |
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