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General NPI Number Information
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NPI Number | 1780576819
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Entity Type | Organization
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Legal Business Name | JJ DENTAL -3
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Dates
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Enumeration Date | 07/15/2025
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Last Update Date | 07/15/2025
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Provider Practice Location Address
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Address Line | 161 S POMPANO PKWY
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City | POMPANO BEACH
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State | FL
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Zip | 33069-3003
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Country | US
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Telephone | 954-595-2231
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Fax |
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Provider Business Mailing Address
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Address Line | 2707 E COMMERCIAL BLVD
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City | FORT LAUDERDALE
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State | FL
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Zip | 33308-4112
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Country | US
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Telephone | 954-595-2231
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | JONATHAN COOK
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Credential | DMD
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Telephone | 954-595-2231
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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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