Provider Demographics
NPI:1790926442
Name:ADVANCED ENDODONTICS AND MICROSURGERY OF FLORIDA, PA
Entity Type:Organization
Organization Name:ADVANCED ENDODONTICS AND MICROSURGERY OF FLORIDA, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:W
Authorized Official - Last Name:SAINSBURY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:954-720-1500
Mailing Address - Street 1:7737 N UNIVERSITY DR
Mailing Address - Street 2:SUITE 204
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-2961
Mailing Address - Country:US
Mailing Address - Phone:954-720-1500
Mailing Address - Fax:954-720-5464
Practice Address - Street 1:7737 N UNIVERSITY DR
Practice Address - Street 2:SUITE 204
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-2961
Practice Address - Country:US
Practice Address - Phone:954-720-1500
Practice Address - Fax:954-720-5464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-10
Last Update Date:2009-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN177291223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty