Provider Demographics
NPI:1881612570
Name:KLUGERMAN, BETHANNE T (DMD)
Entity type:Individual
Prefix:DR
First Name:BETHANNE
Middle Name:T
Last Name:KLUGERMAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8501 SW 124TH AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-4627
Mailing Address - Country:US
Mailing Address - Phone:305-274-6500
Mailing Address - Fax:305-274-0920
Practice Address - Street 1:8501 SW 124TH AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-4627
Practice Address - Country:US
Practice Address - Phone:305-274-6500
Practice Address - Fax:305-274-0920
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN00009344122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist