Organization
AMP ORAL AND MAXILLOFACIAL SURGERY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN CLINTON ELMORE DDS (OWNER/AUTHORIZED OFFICIAL)
(678) 480-9808
Entity
Organization
Contact information
Practice address
3861 AVALON PARK EAST BLVD, ORLANDO, FL 32828-4853
(407) 544-0139
Mailing address
10524 MOSS PARK RD STE 204-616, ORLANDO, FL 32832-5898
(678) 480-9808
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
02/09/2021
Last updated
04/22/2024
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