Provider Demographics
NPI:1396953360
Name:BELKIS C DEL PUERTO, DMD, PA
Entity type:Organization
Organization Name:BELKIS C DEL PUERTO, DMD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR, OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BELKIS
Authorized Official - Middle Name:C
Authorized Official - Last Name:DEL PUERTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-597-2227
Mailing Address - Street 1:11402 NW 41ST ST STE 214
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-4861
Mailing Address - Country:US
Mailing Address - Phone:305-597-2227
Mailing Address - Fax:305-591-5702
Practice Address - Street 1:11402 NW 41ST ST STE 214
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178-4861
Practice Address - Country:US
Practice Address - Phone:305-597-2227
Practice Address - Fax:305-591-5702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN00142811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty