MEDICARE: DR. GORDON E. BYERS DDS, PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1063530483
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. GORDON E. BYERS DDS, PA

Provider Business Mailing Address
First Line	:	835 22ND ST
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32960-5104
Country	:	US
Telephone Number	:	772-562-9029
Fax Number	:	772-562-9903

Provider Business Practice Location Address
First Line	:	835 22ND ST
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32960-5104
Country	:	US
Telephone Number	:	772-562-9029
Fax Number	:	772-562-9903

Authorized Official
Title or Position	:	PRESIDENT
Name	:	GORDON BYERS
Credential	:	DDS
Telephone Number	:	772-562-9029

Provider Enumeration Date	:	03/26/2007
Last Update Date	:	08/22/2020

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