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Organization

INTERCOASTAL DENTAL PLLC

Active
Other names
Intercoastal Dental PLLC
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ALEXANDRE EIAN GAETA DDS (PRESIDENT)
(626) 264-0182
Entity
Organization

Contact information

Practice address
11940 US 1 STE 245, PALM BEACH GARDENS, FL 33408-2832
(626) 264-0182
Mailing address
104 SANTA BARBARA WAY, PALM BEACH GARDENS, FL 33410-4319

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Enumeration date
08/02/2022
Last updated
08/02/2022
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