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General NPI Number Information
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NPI Number | 1194263541
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Entity Type | Organization
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Legal Business Name | DENTAL IMPLANTS OF OCALA
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Dates
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Enumeration Date | 02/06/2017
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Last Update Date | 02/06/2017
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Provider Practice Location Address
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Address Line | 7550 SW 61ST AVE SUITE 2
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City | OCALA
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State | FL
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Zip | 34476-8310
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Country | US
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Telephone | 352-653-2500
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Fax | 352-671-1093
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Provider Business Mailing Address
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Address Line | 7550 SW 61ST AVE SUITE 2
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City | OCALA
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State | FL
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Zip | 34476-8310
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Country | US
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Telephone | 352-653-2500
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Fax | 352-671-1093
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. NICKELICE BRAND
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Credential | DDS
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Telephone | 352-653-2500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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