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General NPI Number Information
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NPI Number | 1225249535
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Entity Type | Organization
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Legal Business Name | ASTRID SAND DDS INCORPORATED
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Dates
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Enumeration Date | 05/25/2007
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Last Update Date | 03/27/2017
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Provider Practice Location Address
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Address Line | 1140 SE 18TH PL
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City | OCALA
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State | FL
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Zip | 34471-5422
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Country | US
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Telephone | 352-620-0093
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Fax |
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Provider Business Mailing Address
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Address Line | 1140 SE 18TH PL
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City | OCALA
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State | FL
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Zip | 34471-5422
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Country | US
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Telephone | 352-620-0093
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ASTRID SAND
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Credential | DDS
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Telephone | 352-620-0093
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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 | DN22324
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License Number State | FL
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