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General NPI Number Information
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NPI Number | 1427963644
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Entity Type | Organization
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Legal Business Name | BECERRA DENTAL FL CORP
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Dates
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Enumeration Date | 08/14/2026
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Last Update Date | 08/14/2026
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Provider Practice Location Address
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Address Line | 10301 HAGEN RANCH RD STE C-140
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City | BOYNTON BEACH
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State | FL
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Zip | 33437-3724
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Country | US
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Telephone | 949-532-8067
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Fax |
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Provider Business Mailing Address
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Address Line | 10301 HAGEN RANCH RD STE C-140
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City | BOYNTON BEACH
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State | FL
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Zip | 33437-3724
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Country | US
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Telephone | 949-532-8067
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | FERNANDO BECERRA
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Credential | DDS
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Telephone | 214-549-6116
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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