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Organization
PC ENDO SOUTH PA
Active
Organization
PC ENDO SOUTH PA
Active
Other names
Advanced Endodontics
Organization subpart
No
Provider details
NPI number
Authorized official
AMBER MAE PERRY (CFO)
(352) 404-5550
Entity
Organization
Contact information
Practice address
1471 JOHNS LAKE RD STE 1, CLERMONT, FL 34711-7005
(352) 404-5550
Mailing address
1471 JOHNS LAKE RD STE 1, CLERMONT, FL 34711-7005
(352) 404-5550
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
—
—
1223P0300X
Periodontics
—
—
Other
Enumeration date
05/26/2015
Last updated
01/22/2020
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