Individual
JEREMY PITTMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2105 PALM BAY RD NE STE 4-5, PALM BAY, FL 32905-2937
(321) 725-7644
Mailing address
11954 NARCOOSSEE RD STE 2, ORLANDO, FL 32832-6998
(229) 672-8411
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DN26631
FL
1223G0001X
General Practice Dentistry
Primary
DN26631
FL
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
07/26/2021
Last updated
02/26/2025
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