Organization
ASPEN DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOLLY BORDELON STANFORD (GENERAL DENTIST)
(337) 298-0673
Entity
Organization
Contact information
Practice address
3411 SW 36TH TER, OCALA, FL 34474-7404
(352) 433-0715
Mailing address
8036 SW 72ND PL, GAINESVILLE, FL 32608-8421
(337) 298-0673
(352) 505-3213
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN20769
FL
Other
Enumeration date
07/09/2014
Last updated
07/09/2014
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