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General NPI Number Information
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NPI Number | 1194211508
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Entity Type | Individual
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Provider Name | SUZET DEL CARMEN MONTES DE OCA CALAS DMD
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Gender | Female
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Dates
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Enumeration Date | 07/09/2018
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Last Update Date | 01/13/2021
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Provider Practice Location Address
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Address Line | 1573 SAXON BLVD STE 100&101
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City | DELTONA
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State | FL
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Zip | 32725
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Country | US
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Telephone | 386-218-0046
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Fax |
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Provider Business Mailing Address
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Address Line | 1573 SAXON BLVD STE 100&101
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City | DELTONA
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State | FL
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Zip | 32725-5833
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Country | US
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Telephone | 386-222-3348
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN23643
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License Number State | FL
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