Healthcare Provider Details

I. General information

NPI: 1871456426
Provider Name (Legal Business Name): ADVANTAGE DENTAL ORAL HEALTH CENTER OF FLORIDA PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2602 SW 87TH DR STE 101
GAINESVILLE FL
32608-9312
US

IV. Provider business mailing address

PO BOX 410042
BOSTON MA
02241-0042
US

V. Phone/Fax

Practice location:
  • Phone: 629-999-5014
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: SHERRIE EDMONDSON
Title or Position: SR MANAGER
Credential:
Phone: 615-598-5572