Organization
JUPITER PEDIATRIC DENTISTRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALYSSA LYNN BENITEZ DMD (OWNER)
(561) 747-3338
Entity
Organization
Contact information
Practice address
654 W INDIANTOWN RD STE 102, JUPITER, FL 33458-7546
(561) 747-3338
(561) 277-2510
Mailing address
654 W INDIANTOWN RD STE 102, JUPITER, FL 33458-7546
(561) 747-3338
(561) 277-2510
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1922521822
NPI
FL
Enumeration date
02/03/2019
Last updated
02/03/2019
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