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General NPI Number Information
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NPI Number | 1457960817
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Entity Type | Organization
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Legal Business Name | VIERA DDS
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Dates
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Enumeration Date | 07/30/2020
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Last Update Date | 07/30/2020
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Provider Practice Location Address
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Address Line | 7185 MURRELL RD STE 102
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City | VIERA
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State | FL
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Zip | 32940-8260
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Country | US
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Telephone | 234-567-8911
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Fax |
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Provider Business Mailing Address
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Address Line | 7185 MURRELL RD STE 102
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City | VIERA
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State | FL
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Zip | 32940-8260
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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 | CONSULTANT
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Name | GINA ABROTSKY
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Credential |
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Telephone | 800-820-0364
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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