Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | DN15483 | FL |
NPI | 1154401677 |
---|---|
Provider Name | Dr. Christopher L Ross |
First Address | Clearwater, FL 33756-2353 |
Second Address | Clearwater, FL 33756-2353 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2006 |
Last Update Date | 08/07/2007 |