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General NPI Number Information
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NPI Number | 1497348270
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Entity Type | Organization
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Legal Business Name | BEACH SMILE FAMILY DENTISTRY, P.A.
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Dates
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Enumeration Date | 02/12/2021
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Last Update Date | 02/12/2021
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Provider Practice Location Address
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Address Line | 2242 NE 123RD ST
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City | NORTH MIAMI
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State | FL
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Zip | 33181-2904
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Country | US
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Telephone | 305-867-2593
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Fax |
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Provider Business Mailing Address
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Address Line | 2242 NE 123RD ST
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City | NORTH MIAMI
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State | FL
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Zip | 33181-2904
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Country | US
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Telephone | 954-483-6933
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. SHANNA BERNKRANT
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Credential | DMD
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Telephone | 954-483-6933
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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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