# GERALD W. BIRD, D.D.S., P.A.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Gerald W. Bird, D.M.D., P.A.
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578793675
- **Authorized official:** DR. GERALD W. BIRD D.D.S. (PRESIDENT)
- **Authorized official phone:** (321) 631-7000

## Contact information

- **Practice address:** 96 WILLARD ST, SUITE 105, COCOA, FL 32922-8008
- **Practice address phone:** (321) 631-7000
- **Practice address fax:** (321) 631-5135
- **Mailing address:** 96 WILLARD ST, SUITE 105, COCOA, FL 32922-8008
- **Mailing address phone:** (321) 631-7000
- **Mailing address fax:** (321) 631-5135

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 10251 | FL | Yes |

## Other

- **Enumeration date:** 07/23/2009
- **Last updated:** 07/23/2009