Healthcare Provider Details

I. General information

NPI: 1912713595
Provider Name (Legal Business Name): TAORMINA DENTAL GROUP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2024
Last Update Date: 12/09/2024
Certification Date: 12/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1851 W INDIANTOWN RD STE 203
JUPITER FL
33458-3954
US

IV. Provider business mailing address

1851 W INDIANTOWN RD STE 203
JUPITER FL
33458-3954
US

V. Phone/Fax

Practice location:
  • Phone: 561-743-8705
  • Fax:
Mailing address:
  • Phone: 561-743-8705
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JENNIFER PERNA
Title or Position: PRESIDENT
Credential: DMD
Phone: 321-794-2030