Healthcare Provider Details

I. General information

NPI: 1427989912
Provider Name (Legal Business Name): DESTIN CENTER FOR ENDODONTICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13370 US HIGHWAY 98 W
MIRAMAR BEACH FL
32550-6835
US

IV. Provider business mailing address

13370 US HIGHWAY 98 W
MIRAMAR BEACH FL
32550-6835
US

V. Phone/Fax

Practice location:
  • Phone: 850-346-8412
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number State

VIII. Authorized Official

Name: PHILLIP BELL
Title or Position: MANAGER
Credential:
Phone: 850-346-8412