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Provider Information for 1033463328



TOMMY GAERTNER D.M.D.

Gender: MALE

Individual NPI: 1033463328

Calendar   Last Updated:  2012-11-08
  Certification Date: 

Details

Name Value
NPI 1033463328
Enumeration Date 2012-11-08
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 2906 S UNIVERSITY DR MAILBOX#10203
DAVIE, FL 33328-1453
United States

Phone: 954-593-4448 | Fax:
View Map External Link
Primary Practice Address 400 W 41ST ST STE 500
MIAMI BEACH, FL 33140-3516
United States

Phone: 954-593-4448 | Fax:
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 122300000X - Dentist FL DN20000