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General NPI Number Information
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NPI Number | 1760270532
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Entity Type | Organization
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Legal Business Name | ENDLESS SUMMER DENTAL CARE PA
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Dates
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Enumeration Date | 04/30/2025
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 615 A1A N STE 103
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City | PONTE VEDRA BEACH
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State | FL
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Zip | 32082-2748
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Country | US
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Telephone | 904-273-9353
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Fax |
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Provider Business Mailing Address
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Address Line | 615 A1A N STE 103
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City | PONTE VEDRA BEACH
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State | FL
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Zip | 32082-2748
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Country | US
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Telephone | 904-273-9353
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. CLAYTON CELANDER
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Credential | DMD
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Telephone | 904-273-9353
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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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