| NPI | 1205079712 |
|---|---|
| Doing Business As | ADVANCED PERIODONTICS |
| Entity Type | Organization |
| Authorized Contact | STEPHEN STROUT Owner/ Dentist 904-794-1824 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: FL DN15749) |
| Enumeration Date | 2009-04-14 |
| Last Update Date | 2009-04-14 |