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General NPI Number Information
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NPI Number | 1942633185
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Entity Type | Organization
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Legal Business Name | JAMILY F. PEDRO, DMD PA
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Dates
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Enumeration Date | 08/12/2013
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Last Update Date | 08/12/2013
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Provider Practice Location Address
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Address Line | 7050 W PALMETTO PARK RD SUITE 52
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City | BOCA RATON
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State | FL
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Zip | 33433-3426
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Country | US
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Telephone | 561-394-2592
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Fax | 561-394-3768
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Provider Business Mailing Address
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Address Line | 7050 W PALMETTO PARK RD SUITE 52
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City | BOCA RATON
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State | FL
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Zip | 33433-3426
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Country | US
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Telephone | 561-394-2592
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Fax | 561-394-3768
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Authorized Official
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Title or Position | OWNER
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Name | MRS. JAMILY F PEDRO
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Credential | DMD
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Telephone | 508-939-0312
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 19518
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License Number State | FL
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