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Organization
BEACH DENTAL SPECIALIST
Active
Organization
BEACH DENTAL SPECIALIST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDY AUGUSTO GUERRA (PRESIDENT)
(305) 424-2705
Entity
Organization
Contact information
Practice address
4011 W FLAGLER ST., 505, MIAMI, FL 33134
(305) 424-2705
(305) 643-0447
Mailing address
4011 W FLAGLER ST., 505, MIAMI, FL 33134
(305) 424-2705
(305) 643-0447
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
DN18777
FL
1223P0300X
Periodontics
Primary
DN18253
FL
Other
Enumeration date
03/06/2013
Last updated
03/06/2013
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