Provider Demographics
NPI:1902952195
Name:GIOL & JAFFE, LLC
Entity Type:Organization
Organization Name:GIOL & JAFFE, LLC
Other - Org Name:REGENCY DENTAL CENTER OF STUART
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ARLENE
Authorized Official - Middle Name:ROXAS
Authorized Official - Last Name:JAFFE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:772-220-7555
Mailing Address - Street 1:2474 SE FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-4531
Mailing Address - Country:US
Mailing Address - Phone:772-220-7555
Mailing Address - Fax:772-220-1016
Practice Address - Street 1:2474 SE FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-4531
Practice Address - Country:US
Practice Address - Phone:772-220-7555
Practice Address - Fax:772-220-1016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-28
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN127261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1223G0001XOtherDENTAL