Mj Dental Services, PA

NPI #1659677714 in Mount Dora, Florida

Provider Information

NPI Number: 1659677714
Entity Type: Organization
Organization Name: Mj Dental Services, PA
Primary Specialty: Dentist
Enumeration Date: Feb 7, 2011
Last Updated: Feb 7, 2011

Practice Location

Address: 2230 WEST OLD HIGHWAY 441
City: Mount Dora
State: Florida
ZIP Code: 32757-3508
Phone: (352) 383-2959

Authorized Official

Name: DR. MITESH JIVAN, DMD
Title: PRESIDENT
Phone: (352) 383-2959

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X
Dental Hygienist	124Q00000X
Dental Assistant	126800000X
Dentist	122300000X	Primary

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