MEDICARE: JRPC DENTAL CARE INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DN19825	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467815951
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JRPC DENTAL CARE INC

Provider Business Mailing Address
First Line	:	5330 S JOHN YOUNG PKWY
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32839-7363
Country	:	US
Telephone Number	:	407-601-7476
Fax Number	:

Provider Business Practice Location Address
First Line	:	5330 S JOHN YOUNG PKWY
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32839-7363
Country	:	US
Telephone Number	:	407-601-7476
Fax Number	:

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. JEAN RENE PIERRE-CHARLES
Credential	:
Telephone Number	:	407-272-5105

Provider Enumeration Date	:	04/01/2016
Last Update Date	:	04/01/2016

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Directions to “JRPC DENTAL CARE INC ” Practice Location

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