| NPI | 1093401424 |
|---|---|
| Doing Business As | ADVANTAGE DENTAL PLUS |
| Entity Type | Organization |
| Authorized Contact | SHERRIE EDMONDSON Sr Manager, L&C 629-999-5014 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 122300000X Dentist |
| 1223P0221X Dentist, Pediatric Dentistry | |
| Enumeration Date | 2023-04-18 |
| Last Update Date | 2023-07-07 |