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General NPI Number Information
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NPI Number | 1285020966
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Entity Type | Organization
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Legal Business Name | SEDATION IMPLANT DENTISTRY PL
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Dates
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Enumeration Date | 04/09/2015
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Last Update Date | 04/09/2015
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Provider Practice Location Address
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Address Line | 4600 SW 46TH CT BUILDING 200, SUITE 360
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City | OCALA
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State | FL
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Zip | 34474-5708
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Country | US
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Telephone | 352-350-1599
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Fax |
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Provider Business Mailing Address
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Address Line | 1809 SE 32ND LN
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City | OCALA
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State | FL
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Zip | 34471-6746
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Country | US
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Telephone | 352-219-4430
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAMIE N AMIR
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Credential | BDS, MS
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Telephone | 352-219-4430
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | DN17958
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License Number State | FL
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