| NPI | 1386412328 |
|---|---|
| Doing Business As | ADVANTAGE DENTAL PLUS |
| Entity Type | Organization |
| Authorized Contact | SHERRIE EDMONDSON Sr Manager 629-999-5014 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 122300000X Dentist |
| 1223P0221X Dentist, Pediatric Dentistry | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery | |
| Enumeration Date | 2023-12-19 |
| Last Update Date | 2024-03-19 |