| Colt Canepa Dmd Llc | |
|
710 Ne Jensen Beach Blvd Jensen Beach FL 34957-4752 | |
| (772) 334-4090 | |
| (772) 334-4837 |
| Full Name | Colt Canepa Dmd Llc |
|---|---|
| Speciality | Dentist |
| Location | 710 Ne Jensen Beach Blvd, Jensen Beach, Florida |
| Authorized Official Name and Position | Colt Canepa (OWNER, DENTIST) |
| Authorized Official Contact | 7724187864 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Colt Canepa Dmd Llc 10926 Se Deer Moss Trl Jupiter FL 33469-8130 Ph: (772) 418-7864 | Colt Canepa Dmd Llc 710 Ne Jensen Beach Blvd Jensen Beach FL 34957-4752 Ph: (772) 334-4090 |
| NPI Number | 1598533762 |
|---|---|
| Provider Enumeration Date | 12/18/2023 |
| Last Update Date | 12/18/2023 |
| Medicare PECOS PAC ID | 7113360389 |
|---|---|
| Medicare Enrollment ID | O20240206000023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598533762 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
| Provider Name | Colt Harrison Canepa |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1801455456 PECOS PAC ID: 8022451293 Enrollment ID: I20240206000027 |
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