Healthcare Provider Details

I. General information

NPI: 1659322014
Provider Name (Legal Business Name): FACULTY ASSOCIATES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 09/15/2021
Certification Date: 09/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD D4-6
GAINESVILLE FL
32610-3003
US

IV. Provider business mailing address

PO BOX 100425 1600 SW ARCHER ROAD
GAINESVILLE FL
32610-0425
US

V. Phone/Fax

Practice location:
  • Phone: 352-273-5800
  • Fax: 352-392-3070
Mailing address:
  • Phone: 352-273-5800
  • Fax: 352-392-3070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. ANA I GARCIA
Title or Position: DEAN
Credential: DDS
Phone: 352-273-5800