Provider Demographics
NPI:1417066531
Name:BELOBRAIDICH, WILLIAM ROBERT (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:ROBERT
Last Name:BELOBRAIDICH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3201 FLAGLER AVE
Mailing Address - Street 2:SUITE 507
Mailing Address - City:KEY WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33040-4690
Mailing Address - Country:US
Mailing Address - Phone:305-294-9999
Mailing Address - Fax:305-294-5499
Practice Address - Street 1:3201 FLAGLER AVE
Practice Address - Street 2:SUITE 507
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-4690
Practice Address - Country:US
Practice Address - Phone:305-294-9999
Practice Address - Fax:305-294-5499
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN00136471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice