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General NPI Number Information
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NPI Number | 1558769794
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Entity Type | Organization
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Legal Business Name | JUBIDENTAL SERVICES CORP
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Dates
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Enumeration Date | 12/19/2014
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Last Update Date | 12/19/2014
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Provider Practice Location Address
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Address Line | 299 ALHAMBRA CIR SUITE # 202
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City | CORAL GABLES
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State | FL
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Zip | 33134-5106
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Country | US
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Telephone | 305-444-3074
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Fax | 844-270-7764
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Provider Business Mailing Address
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Address Line | 299 ALHAMBRA CIR SUITE # 202
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City | CORAL GABLES
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State | FL
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Zip | 33134-5106
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Country | US
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Telephone | 305-444-3074
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Fax | 844-270-7764
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Authorized Official
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Title or Position | DOCTOR / OWNER
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Name | DR. YANEPSI COTELO-PARDO
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Credential | DDS
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Telephone | 305-444-3074
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN20131
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License Number State | FL
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