Organization
ASSOCIATED ENDODONTISTS OF LAKE CITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE WALTERS (RECEIPTIONIST)
(386) 758-6050
Entity
Organization
Contact information
Practice address
2086 SW MAIN BLVD STE 113, LAKE CITY, FL 32025-0006
(386) 758-6050
(386) 758-7742
Mailing address
2086 SW MAIN BLVD STE 113, LAKE CITY, FL 32025-0006
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
DN 5418
FL
Other
Enumeration date
06/21/2011
Last updated
06/21/2011
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