Provider Demographics
NPI:1841518586
Name:TOWNCARE DENTAL OF JUPITER, PA
Entity type:Organization
Organization Name:TOWNCARE DENTAL OF JUPITER, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BILECA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-274-2499
Mailing Address - Street 1:13195 SW 134TH ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-4461
Mailing Address - Country:US
Mailing Address - Phone:305-274-2499
Mailing Address - Fax:305-274-2899
Practice Address - Street 1:5440 MILITARY TRL STE 11
Practice Address - Street 2:SUITE 11
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-2867
Practice Address - Country:US
Practice Address - Phone:561-627-6090
Practice Address - Fax:561-627-6088
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOWNCARE DENTAL PARTNERSHIP, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-05-05
Last Update Date:2010-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty