Organization
SONDRA L AVANT DDS MS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SONDRA AVANT DDS MS (OWNER)
(386) 304-4620
Entity
Organization
Contact information
Practice address
731 DUNLAWTON AVE STE 105, PORT ORANGE, FL 32127-4237
(386) 304-4620
(386) 304-4619
Mailing address
731 DUNLAWTON AVE STE 105, PORT ORANGE, FL 32127-4237
(386) 304-4620
(386) 304-4619
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
DN13606
FL
261QD0000X
Dental Clinic/Center
DN13606
FL
Other
Enumeration date
10/31/2016
Last updated
10/31/2016
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