| Amp Oral And Maxillofacial Surgery, Pa | |
|
3861 Avalon Park East Blvd Orlando FL 32828-4853 | |
| (407) 544-0139 | |
| Not Available |
| Full Name | Amp Oral And Maxillofacial Surgery, Pa |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 3861 Avalon Park East Blvd, Orlando, Florida |
| Authorized Official Name and Position | Jonathan Clinton Elmore (OWNER/AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 6784809808 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Amp Oral And Maxillofacial Surgery, Pa 10524 Moss Park Rd Ste 204-616 Orlando FL 32832-5898 Ph: (678) 480-9808 | Amp Oral And Maxillofacial Surgery, Pa 3861 Avalon Park East Blvd Orlando FL 32828-4853 Ph: (407) 544-0139 |
| NPI Number | 1144812348 |
|---|---|
| Provider Enumeration Date | 02/09/2021 |
| Last Update Date | 04/22/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144812348 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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