Organization
CLERMONT ENDODONTIC SPECIALIST, P.A.
Active
Parent organization
CLERMONT ENDODONTIC SPECIALIST, P.A.
Organization subpart
Yes
Provider details
NPI number
Legal business name
CLERMONT ENDODONTIC SPECIALIST, P.A.
Authorized official
PAM HARDIEK (CREDENTIALING/INSURANCE)
(217) 540-5100
Entity
Organization
Contact information
Practice address
265 HATTERAS AVE, SUITE 2, CLERMONT, FL 34711-7400
(352) 394-0150
(352) 243-0654
Mailing address
265 HATTERAS AVE, SUITE 2, CLERMONT, FL 34711-7400
(352) 394-0150
(352) 243-0654
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
—
—
Other
Enumeration date
05/03/2012
Last updated
05/03/2012
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