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Organization
PIMENDENT II, PA
Active
Organization
PIMENDENT II, PA
Active
Other names
Aspen Dental
Organization subpart
No
Provider details
NPI number
Authorized official
AMY MARKO (VP INS OPS)
(315) 454-6000
Entity
Organization
Contact information
Practice address
1812 DUNLAWTON AVE STE 101, PORT ORANGE, FL 32127-2925
(386) 233-3040
(386) 756-8810
Mailing address
PO BOX 3189, SYRACUSE, NY 13220-3189
(315) 454-6000
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
17338
FL
Other
Enumeration date
03/19/2014
Last updated
03/19/2014
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