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Individual

EDNA L CLINTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
7205 SE MARICAMP RD, OCALA, FL 34472-2105
(352) 680-0324
(352) 680-0173
Mailing address
1425 S US 301, SUMTERVILLE, FL 33585-5141
(352) 793-5900
(352) 793-8050

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN19878
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
006788500
FL
01
631KP
BCBS
FL
Enumeration date
10/18/2010
Last updated
07/01/2013
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