# DR AFSOON ELMORE DDS PLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194115956
- **Authorized official:** DR. AFSOON ELMORE DDS (OWNER)
- **Authorized official phone:** (407) 629-6464

## Contact information

- **Practice address:** 668 N ORLANDO AVE, SUITE1008, MAITLAND, FL 32751-4473
- **Practice address phone:** (407) 629-6464
- **Practice address fax:** (407) 629-0031
- **Mailing address:** 668 N ORLANDO AVE, SUITE1008, MAITLAND, FL 32751-4473
- **Mailing address phone:** (407) 629-6464
- **Mailing address fax:** (407) 629-0031

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | DN16958 | FL | Yes |

## Other

- **Enumeration date:** 02/02/2015
- **Last updated:** 02/02/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 075545100 | — | FL |