| Jupiter Prosthodontics | |
|
200 Central Blvd Ste A Jupiter FL 33458 | |
| (561) 745-5550 | |
| (561) 745-8442 |
| Full Name | Jupiter Prosthodontics |
|---|---|
| Speciality | Dentist - Prosthodontics |
| Location | 200 Central Blvd, Jupiter, Florida |
| Authorized Official Name and Position | Roy C Blake (OWNER MANAGER) |
| Authorized Official Contact | 5617455550 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jupiter Prosthodontics 200 Central Blvd Ste A Jupiter FL 33458 Ph: (561) 745-5550 | Jupiter Prosthodontics 200 Central Blvd Ste A Jupiter FL 33458 Ph: (561) 745-5550 |
| NPI Number | 1114006434 |
|---|---|
| Provider Enumeration Date | 11/06/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114006434 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0700X | Dentist - Prosthodontics | DN9551 (Florida) | Primary |
| 1223P0700X | Dentist - Prosthodontics | DN16512 (Florida) | Secondary |
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