MEDICARE: SUNSET FAMILY AND COSMETIC DENTISTRY, PLLC

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	261QD0000X	Dental Clinic/Center	DN20181	FL

General Provider Information

NPI Number	:	1154762565
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNSET FAMILY AND COSMETIC DENTISTRY, PLLC

Provider Business Mailing Address
First Line	:	9777 SW 72ND ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33173-4615
Country	:	US
Telephone Number	:	305-763-6220
Fax Number	:	305-596-1820

Provider Business Practice Location Address
First Line	:	9777 SW 72ND ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33173-4615
Country	:	US
Telephone Number	:	305-763-6220
Fax Number	:	305-596-1820

Authorized Official
Title or Position	:	DOCTOR OF DENTAL MEDICINE
Name	:	DR. EDUARDO UBIETA ARBESU
Credential	:	DMD
Telephone Number	:	305-596-2815

Provider Enumeration Date	:	07/13/2013
Last Update Date	:	12/31/2013

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