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Organization
MJ DENTAL SERVICES, PA
Active
Organization
MJ DENTAL SERVICES, PA
Active
Other names
Mitesh Jivan DMD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MITESH JIVAN DMD (PRESIDENT)
(352) 383-2959
Entity
Organization
Contact information
Practice address
2230 WEST OLD HIGHWAY 441, MOUNT DORA, FL 32757-3508
(352) 383-2959
(352) 735-3355
Mailing address
2230 WEST OLD HIGHWAY 441, MOUNT DORA, FL 32757-3508
(352) 383-2959
(352) 735-3355
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN18726
FL
1223G0001X
General Practice Dentistry
DN6360
FL
124Q00000X
Dental Hygienist
DH15460
FL
124Q00000X
Dental Hygienist
DH5118
FL
124Q00000X
Dental Hygienist
DH5702
FL
126800000X
Dental Assistant
106953
FL
Other
Enumeration date
02/07/2011
Last updated
02/07/2011
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