Provider Demographics
NPI:1912713595
Name:TAORMINA DENTAL GROUP PLLC
Entity type:Organization
Organization Name:TAORMINA DENTAL GROUP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:PERNA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:321-794-2030
Mailing Address - Street 1:1851 W INDIANTOWN RD STE 203
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-3954
Mailing Address - Country:US
Mailing Address - Phone:561-743-8705
Mailing Address - Fax:
Practice Address - Street 1:1851 W INDIANTOWN RD STE 203
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-3954
Practice Address - Country:US
Practice Address - Phone:561-743-8705
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-09
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental