Provider Demographics
NPI:1639939895
Name:ROYAL PALM DENTAL ARTS LLC
Entity type:Organization
Organization Name:ROYAL PALM DENTAL ARTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:
Authorized Official - Last Name:ELEFANT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:561-333-3556
Mailing Address - Street 1:11440 OKEECHOBEE BLVD STE 106
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-8707
Mailing Address - Country:US
Mailing Address - Phone:732-996-2447
Mailing Address - Fax:
Practice Address - Street 1:11440 OKEECHOBEE BLVD STE 106
Practice Address - Street 2:
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-8707
Practice Address - Country:US
Practice Address - Phone:732-996-2447
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-22
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental