| Advanced Periodontics | |
|
1542 Kingsley Ave Suite 135 Orange Park FL 32073-4586 | |
| (904) 278-6980 | |
| (904) 278-5201 |
| Full Name | Advanced Periodontics |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 1542 Kingsley Ave, Orange Park, Florida |
| Authorized Official Name and Position | Stephen Strout (OWNER/ DENTIST) |
| Authorized Official Contact | 9047941824 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Periodontics 1542 Kingsley Ave Suite 135 Orange Park FL 32073-4586 Ph: (904) 278-6980 | Advanced Periodontics 1542 Kingsley Ave Suite 135 Orange Park FL 32073-4586 Ph: (904) 278-6980 |
| NPI Number | 1205079712 |
|---|---|
| Provider Enumeration Date | 04/14/2009 |
| Last Update Date | 04/14/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205079712 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | DN15749 (Florida) | Primary |
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