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General NPI Number Information
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NPI Number | 1972619203
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Entity Type | Individual
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Provider Name | EROS SANTOS CHAVES DDS, MS, DMD
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Gender | Male
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 10/04/2007
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Provider Practice Location Address
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Address Line | 3755 20TH PL
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City | VERO BEACH
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State | FL
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Zip | 32960-2302
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Country | US
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Telephone | 772-569-0123
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Fax | 772-569-9070
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Provider Business Mailing Address
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Address Line | 935 43RD TER SW
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City | VERO BEACH
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State | FL
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Zip | 32968-4886
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Country | US
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Telephone | 772-299-4112
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | DN 15531
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 19496
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License Number State | TX
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