Organization
PC ENDO SOUTH PA
Active
Other names
Advanced Endodontics
Organization subpart
No
Provider details
NPI number
Authorized official
AMBER MAE PERRY (CFO)
(352) 404-5550
Entity
Organization
Contact information
Practice address
1471 JOHNS LAKE RD STE 1, CLERMONT, FL 34711-7005
(352) 404-5550
Mailing address
1471 JOHNS LAKE RD STE 1, CLERMONT, FL 34711-7005
(352) 404-5550
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
—
—
1223P0300X
Periodontics
—
—
Other
Enumeration date
05/26/2015
Last updated
01/22/2020
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