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Organization

JUPITER PROSTHODONTICS

Active
Other names
Jupiter Institute for Prosthodontics & Implant Dentistry
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ROY C BLAKE III DDS MSD (OWNER MANAGER)
(561) 745-5550
Entity
Organization

Contact information

Practice address
200 CENTRAL BLVD, STE A, JUPITER, FL 33458
(561) 745-5550
(561) 745-8442
Mailing address
200 CENTRAL BLVD, STE A, JUPITER, FL 33458
(561) 745-5550
(561) 745-8442

Taxonomy

Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
DN16512
FL
1223P0700X
Prosthodontics
Primary
DN9551
FL

Other

Enumeration date
11/06/2006
Last updated
08/22/2020
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