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General NPI Number Information
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NPI Number | 1881615359
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Entity Type | Individual
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Provider Name | JUAN CARLOS BIRD D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/21/2006
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Last Update Date | 10/13/2008
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Provider Practice Location Address
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Address Line | 401 MIRACLE MILE STE 411
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City | CORAL GABLES
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State | FL
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Zip | 33134-4926
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Country | US
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Telephone | 305-648-9190
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Fax | 305-648-9191
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Provider Business Mailing Address
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Address Line | 10249 SW 162ND CT
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City | MIAMI
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State | FL
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Zip | 33196-5892
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Country | US
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Telephone | 305-386-2713
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | DN14260
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License Number State | FL
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