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General NPI Number Information
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NPI Number | 1487705646
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Entity Type | Organization
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Legal Business Name | BETHANNE KLUGERMAN DMD PA
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Dates
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Enumeration Date | 01/15/2007
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Last Update Date | 09/11/2012
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Provider Practice Location Address
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Address Line | 8501 SW 124TH AVE SUITE 104
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City | MIAMI
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State | FL
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Zip | 33183-4627
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Country | US
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Telephone | 305-274-6500
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Fax | 305-274-0920
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Provider Business Mailing Address
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Address Line | 8501 SW 124TH AVE SUITE 104
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City | MIAMI
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State | FL
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Zip | 33183-4627
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Country | US
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Telephone | 305-274-6500
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Fax | 305-274-0920
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BETHANNE T KLUGERMAN
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Credential | DMD
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Telephone | 305-274-6500
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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 | DN00009344
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License Number State | FL
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