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NPI Code Detail

MEDICARE: DR. JAY BARRY KNOLLER D.M.D.

MEDICARE:  DR. JAY BARRY KNOLLER  D.M.D.
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
11223G0001XGeneral Practice DentistryDN10088FL

General Provider Information

NPI Number : 1558476267
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAY BARRY KNOLLER D.M.D.
Provider Business Mailing Address
First Line : 1236 ROYAL PALM BEACH BLVD
Second Line :
City : ROYAL PALM BEACH
State : FL
Zip : 33411-1602
Country : US
Telephone Number : 561-795-1404
Fax Number :
Provider Business Practice Location Address
First Line : 1236 ROYAL PALM BEACH BLVD
Second Line :
City : ROYAL PALM BEACH
State : FL
Zip : 33411-1602
Country : US
Telephone Number : 561-795-1404
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2006
Last Update Date : 07/08/2007

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Directions to “ DR. JAY BARRY KNOLLER D.M.D.” Practice Location

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