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Organization

JUPITER DENTAL GROUP PLLC

Active
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Organization

JUPITER DENTAL GROUP PLLC

Active
Other names
Kids Dental Zone
Organization subpart
No

Provider details

NPI number
Authorized official
DR. STEVEN COFFMAN DMD (PRESIDENT)
(702) 300-7886
Entity
Organization

Contact information

Practice address
11000 GARLAND RD, DALLAS, TX 75218-2615
(214) 328-4867
Mailing address
PO BOX 939, LAKE DALLAS, TX 75065-0939

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
23791
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
205190609
TX
Enumeration date
10/01/2013
Last updated
02/26/2014
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