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General NPI Number Information
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NPI Number | 1598412991
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Entity Type | Individual
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Provider Name | LYRIC JORDAN HILDEBRANDT DMD
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Gender | Female
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Dates
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Enumeration Date | 03/05/2022
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Last Update Date | 06/28/2024
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Provider Practice Location Address
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Address Line | 1209 MAIN ST STE 114
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City | JUPITER
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State | FL
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Zip | 33458-5244
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Country | US
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Telephone | 561-320-4303
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Fax |
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Provider Business Mailing Address
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Address Line | 38 WINDSOR LN
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33418-7188
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DN28690
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License Number State | FL
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