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General NPI Number Information
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NPI Number | 1033463328
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Entity Type | Individual
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Provider Name | TOMMY GAERTNER D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/08/2012
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Last Update Date | 11/08/2012
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Provider Practice Location Address
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Address Line | 400 W 41ST ST STE 500
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City | MIAMI BEACH
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State | FL
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Zip | 33140-3516
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Country | US
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Telephone | 954-593-4448
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Fax |
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Provider Business Mailing Address
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Address Line | 2906 S UNIVERSITY DR MAILBOX#10203
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City | DAVIE
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State | FL
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Zip | 33328-1453
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Country | US
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Telephone | 954-593-4448
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN20000
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License Number State | FL
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