Provider Demographics
NPI:1811208853
Name:CONTESTABLE, CLEMENT JAMES (DMD)
Entity Type:Individual
Prefix:
First Name:CLEMENT
Middle Name:JAMES
Last Name:CONTESTABLE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 S EOLA DR UNIT 508
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32801-2892
Mailing Address - Country:US
Mailing Address - Phone:321-356-5497
Mailing Address - Fax:
Practice Address - Street 1:4307 E COLONIAL DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-5217
Practice Address - Country:US
Practice Address - Phone:407-362-7705
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-24
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN190661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice