Provider Demographics
NPI:1831219070
Name:MASTER, JANICE M (DDS)
Entity type:Individual
Prefix:DR
First Name:JANICE
Middle Name:M
Last Name:MASTER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 CLEMATIS ST
Mailing Address - Street 2:APT. 717
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-5398
Mailing Address - Country:US
Mailing Address - Phone:561-277-7258
Mailing Address - Fax:
Practice Address - Street 1:2830 SE FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-5738
Practice Address - Country:US
Practice Address - Phone:772-219-2224
Practice Address - Fax:772-219-2216
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN165711223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics