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General NPI Number Information
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NPI Number | 1386341493
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Entity Type | Organization
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Legal Business Name | JASON EHRENMAN DMD MSD LLC
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Dates
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Enumeration Date | 02/09/2023
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Last Update Date | 02/09/2023
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Provider Practice Location Address
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Address Line | 1216 US HIGHWAY 1 STE B
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City | NORTH PALM BEACH
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State | FL
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Zip | 33408-3537
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Country | US
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Telephone | 561-624-5307
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Fax |
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Provider Business Mailing Address
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Address Line | 1216 US HIGHWAY 1 STE B
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City | NORTH PALM BEACH
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State | FL
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Zip | 33408-3537
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Country | US
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Telephone | 561-624-5307
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DR. JASON SCOTT EHRENMAN
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Credential | DMD
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Telephone | 954-803-8941
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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