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General NPI Number Information
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NPI Number | 1285710194
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Entity Type | Organization
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Legal Business Name | BECERRAS FAMILY DENTISTRY
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Dates
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Enumeration Date | 10/31/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 936 SW 82 AVE
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City | MIAMI
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State | FL
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Zip | 33144
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Country | US
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Telephone | 305-269-1440
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Fax |
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Provider Business Mailing Address
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Address Line | 936 SW 82 AVE
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City | MIAMI
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State | FL
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Zip | 33144
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARIA BECERRA
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Credential | DMD
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Telephone | 305-269-1440
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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 |
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License Number State |
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