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NPI 1851420996

NPI 1851420996 : BELLO-BURGOS, D.M.D., D.D.S., PA : MIAMI, FL

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General NPI Number Information
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    NPI Number           |    1851420996
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    Entity Type          |    Organization 
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    Legal Business Name  |    BELLO-BURGOS, D.M.D., D.D.S., PA 
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Dates
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    Enumeration Date     |    03/05/2007
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    Last Update Date     |    04/15/2009
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Provider Practice Location Address
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    Address Line         |    14252 SW 8TH ST 
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    City                 |    MIAMI
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    State                |    FL
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    Zip                  |    33184-3100
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    Country              |    US
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    Telephone            |    305-553-5980
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    Fax                  |    305-553-5981
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Provider Business Mailing Address
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    Address Line         |    12095 NW 5TH ST 
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    City                 |    MIAMI
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    State                |    FL
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    Zip                  |    33182-1343
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    Country              |    US
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    Telephone            |    305-553-5980
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    Fax                  |    305-553-3981
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Authorized Official
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    Title or Position    |    PRESIDENT
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    Name                 |    DR. TERESA J. BELLO-BURGOS 
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    Credential           |    D.M.D., D.D.S.
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    Telephone            |    305-477-5299
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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       |    DN15625
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    License Number State |    FL
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