Organization
CANDESCENT PRESTIGE LLC
Active
Other names
Prestige Dermatology
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEPHEN M JENKS (DIRECTOR/CEO)
(617) 262-1450
Entity
Organization
Contact information
Practice address
4546 GRAND BLVD, NEW PORT RICHEY, FL 34652-5119
(727) 849-1447
Mailing address
4546 GRAND BLVD, NEW PORT RICHEY, FL 34652-5119
(727) 849-1447
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
OS7718
FL
Other
Enumeration date
06/08/2011
Last updated
06/08/2011
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