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General NPI Number Information
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NPI Number | 1215199138
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Entity Type | Organization
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Legal Business Name | OCALA ENDODONTICS
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Dates
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Enumeration Date | 07/01/2008
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Last Update Date | 07/01/2008
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Provider Practice Location Address
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Address Line | 3201 SW 34TH AVE STE 204
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City | OCALA
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State | FL
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Zip | 34474-8471
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Country | US
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Telephone | 352-237-1202
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Fax | 352-237-7722
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Provider Business Mailing Address
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Address Line | 3201 SW 34TH AVE STE 204
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City | OCALA
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State | FL
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Zip | 34474-8471
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Country | US
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Telephone | 352-237-1202
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Fax | 352-237-7722
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Authorized Official
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Title or Position | OWNER
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Name | ELIZABETH C NIXON
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Credential | D.D.S.
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Telephone | 352-273-1202
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | DN 14769
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License Number State | FL
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