Provider Demographics
NPI:1164779351
Name:BYG DENTAL CORP
Entity Type:Organization
Organization Name:BYG DENTAL CORP
Other - Org Name:SMILE PLUS HOMESTEAD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/DR
Authorized Official - Prefix:DR
Authorized Official - First Name:LESTER
Authorized Official - Middle Name:O
Authorized Official - Last Name:GIL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:305-247-5161
Mailing Address - Street 1:963 N KROME AVE
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33030-4408
Mailing Address - Country:US
Mailing Address - Phone:305-247-5161
Mailing Address - Fax:305-247-5120
Practice Address - Street 1:963 N KROME AVE
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-4408
Practice Address - Country:US
Practice Address - Phone:305-247-5161
Practice Address - Fax:305-247-5120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-07
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN18301122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty