| Shorelinesmiles Pa | |
|
1230 W Indiantown Rd Suite 101 Jupiter FL 33458-3904 | |
| (561) 743-8877 | |
| Not Available |
| Full Name | Shorelinesmiles Pa |
|---|---|
| Speciality | Dentist |
| Location | 1230 W Indiantown Rd, Jupiter, Florida |
| Authorized Official Name and Position | Jeff V. Riso (OWNER) |
| Authorized Official Contact | 5617438877 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shorelinesmiles Pa 1230 W Indiantown Rd Suite 101 Jupiter FL 33458-8825 Ph: (561) 743-8877 | Shorelinesmiles Pa 1230 W Indiantown Rd Suite 101 Jupiter FL 33458-3904 Ph: (561) 743-8877 |
| NPI Number | 1922405901 |
|---|---|
| Provider Enumeration Date | 11/19/2014 |
| Last Update Date | 11/19/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922405901 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DN16427 (Florida) | Primary |
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