Organization
ADVANCED PERIODONTICS & IMPLANT CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN WALTER BONNER D.D.S. (PRESIDENT)
(352) 750-4075
Entity
Organization
Contact information
Practice address
1950 LAUREL MANOR DRIVE #184, THE VILLAGES, FL 32162
(352) 750-4075
(352) 750-8072
Mailing address
1950 LAUREL MANOR DRIVE #184, THE VILLAGES, FL 32162
(352) 750-4075
(352) 750-8072
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
—
Other
Enumeration date
05/29/2020
Last updated
05/29/2020
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