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General NPI Number Information
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NPI Number | 1902935570
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Entity Type | Organization
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Legal Business Name | BELLLO-BURGOS, D.M.D. , P.A.
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Dates
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Enumeration Date | 03/02/2007
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Last Update Date | 04/15/2009
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Provider Practice Location Address
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Address Line | 9757 NW 41ST ST
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City | DORAL
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State | FL
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Zip | 33178-2381
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Country | US
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Telephone | 305-477-5299
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Fax | 305-477-5219
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Provider Business Mailing Address
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Address Line | 12095 NW 5TH ST
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City | DORAL
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State | FL
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Zip | 33182-1343
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Country | US
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Telephone | 395-477-5299
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Fax | 305-477-5219
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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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