Provider Demographics
NPI:1063530483
Name:DR. GORDON E. BYERS DDS, PA
Entity type:Organization
Organization Name:DR. GORDON E. BYERS DDS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GORDON
Authorized Official - Middle Name:
Authorized Official - Last Name:BYERS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:772-562-9029
Mailing Address - Street 1:835 22ND ST
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-5104
Mailing Address - Country:US
Mailing Address - Phone:772-562-9029
Mailing Address - Fax:772-562-9903
Practice Address - Street 1:835 22ND ST
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-5104
Practice Address - Country:US
Practice Address - Phone:772-562-9029
Practice Address - Fax:772-562-9903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty