Organization · Type 2 NPI
Jaishiva PA
Dental Clinic/Center · Port St. Lucie, FL
NPI number
1669068375
Active
Practice location
466 SW Port St Lucie Blvd Ste 117
Port St. Lucie, FL 34953-2091
Fax (772) 918-9022
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dental Clinic/Center Primary | 261QD0000X | None listed |
Dental Clinic/Center: Definition to come...
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About NPI 1669068375
Jaishiva PA's National Provider Identifier is 1669068375, issued on Dec 16, 2020. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Port St. Lucie, FL. The record was last updated on Dec 16, 2020.