| Jaishiva Pa | |
|
466 Sw Port St Lucie Blvd Ste 117 Port Saint Lucie FL 34953-2091 | |
| (772) 918-9034 | |
| (772) 918-9022 |
| Full Name | Jaishiva Pa |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 466 Sw Port St Lucie Blvd Ste 117, Port Saint Lucie, Florida |
| Authorized Official Name and Position | Payal P Chokshi (DENTIST/OWNER) |
| Authorized Official Contact | 5617030219 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jaishiva Pa 466 Sw Port St Lucie Blvd Ste 117 Port Saint Lucie FL 34953-2091 Ph: (772) 918-9034 | Jaishiva Pa 466 Sw Port St Lucie Blvd Ste 117 Port Saint Lucie FL 34953-2091 Ph: (772) 918-9034 |
| NPI Number | 1669068375 |
|---|---|
| Provider Enumeration Date | 12/16/2020 |
| Last Update Date | 12/16/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669068375 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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