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General NPI Number Information
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NPI Number | 1396669271
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Entity Type | Organization
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Legal Business Name | ROOT CANAL SPECIALIST OF ORLANDO LLC
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Dates
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Enumeration Date | 08/05/2026
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Last Update Date | 08/05/2026
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Provider Practice Location Address
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Address Line | 4861 S ORANGE AVE STE C
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City | ORLANDO
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State | FL
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Zip | 32806-6949
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Country | US
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Telephone | 407-604-4115
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Fax | 407-542-7463
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Provider Business Mailing Address
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Address Line | 4861 S ORANGE AVE STE C
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City | ORLANDO
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State | FL
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Zip | 32806-6949
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Country | US
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Telephone | 407-604-4115
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Fax | 407-542-7463
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Authorized Official
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Title or Position | PROVIDER/OWNER
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Name | JAMES B LOGSDON
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Credential | D.D.S.
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Telephone | 407-890-9116
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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