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General NPI Number Information
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NPI Number | 1730726720
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Entity Type | Organization
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Legal Business Name | PENSACOLA CENTER FOR ENDODONTICS, LLC
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Dates
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Enumeration Date | 12/09/2019
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Last Update Date | 12/09/2019
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Provider Practice Location Address
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Address Line | 1108 AIRPORT BLVD STE B
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City | PENSACOLA
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State | FL
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Zip | 32504-8623
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Country | US
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Telephone | 850-346-8412
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Fax |
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Provider Business Mailing Address
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Address Line | 16216 FROSTWATCH CIR
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City | CHARLOTTE
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State | NC
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Zip | 28277-4851
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PHILLIP BELL
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Credential | DMD
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Telephone | 850-346-8412
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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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