Organization
MAIN STREET CHILDREN'S DENTISTRY OF JUPITER, PA
Active
Other names
Main Street Orthodontics of Jupiter
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE GOMEZ (PROVIDER RELATIONS)
(305) 274-2499
Entity
Organization
Contact information
Practice address
5440 MILITARY TRAIL SUITE 11, JUPITER, FL 33458
(561) 745-2881
Mailing address
13195 SW 134 ST, 2ND FLOOR, MIAMI, FL 33186
(305) 274-2499
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
08/31/2006
Last updated
08/21/2014
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