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General NPI Number Information
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NPI Number | 1265560148
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Entity Type | Individual
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Provider Name | BERNARD W SEGALL D.M.D.,M.S.
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Gender | Male
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Dates
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Enumeration Date | 03/01/2007
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Last Update Date | 05/25/2011
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Provider Practice Location Address
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Address Line | 2601 S BAYSHORE DR SUITE # 760
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City | COCONUT GROVE
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State | FL
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Zip | 33133-5417
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Country | US
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Telephone | 305-857-0990
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Fax | 305-857-9180
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Provider Business Mailing Address
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Address Line | 2601 S BAYSHORE DR SUITE # 760
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City | COCONUT GROVE
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State | FL
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Zip | 33133-5417
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Country | US
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Telephone | 305-857-0990
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Fax | 305-857-9180
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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 | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | DN0005796
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License Number State | FL
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