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General NPI Number Information
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NPI Number | 1023944592
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Entity Type | Organization
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Legal Business Name | BOLD BITE ORTHODONTICS PLLC
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Dates
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Enumeration Date | 06/22/2026
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Last Update Date | 06/22/2026
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Provider Practice Location Address
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Address Line | 14035 BEACH BLVD STE 104
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City | JACKSONVILLE
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State | FL
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Zip | 32250-1507
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Country | US
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Telephone | 904-595-6869
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Fax |
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Provider Business Mailing Address
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Address Line | 14035 BEACH BLVD STE 104
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City | JACKSONVILLE
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State | FL
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Zip | 32250-1507
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Country | US
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Telephone | 904-595-6869
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Fax |
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Authorized Official
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Title or Position | OWNER/ORTHODONTIST
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Name | MARTIN GREENBERG
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Credential | DMD
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Telephone | 407-227-0721
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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