Provider Demographics
NPI:1356644728
Name:BERNARDO CAMPOS D.D.S. , P.A.
Entity Type:Organization
Organization Name:BERNARDO CAMPOS D.D.S. , P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BERNARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPOS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:305-557-5282
Mailing Address - Street 1:1462 W 84TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33014-3363
Mailing Address - Country:US
Mailing Address - Phone:305-557-5282
Mailing Address - Fax:305-557-4712
Practice Address - Street 1:1462 W 84TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33014-3363
Practice Address - Country:US
Practice Address - Phone:305-557-5282
Practice Address - Fax:305-557-4712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-07
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty