Organization
ADVANTAGE DENTAL ORAL HEALTH CENTER OF FLORIDA PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHERRIE EDMONDSON (MANAGER, LICENSING & CREDENTIALING)
(629) 999-5014
Entity
Organization
Contact information
Practice address
4906 HIGHWAY 90, PACE, FL 32571-1412
(629) 999-5014
Mailing address
3322 W END AVE STE 400, NASHVILLE, TN 37203-6805
(629) 999-5014
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
261QD0000X
Dental Clinic/Center
—
—
Other
Enumeration date
04/01/2022
Last updated
04/06/2022
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