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General NPI Number Information
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NPI Number | 1942558077
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Entity Type | Organization
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Legal Business Name | OCAMPO DDS PLLC
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Dates
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Enumeration Date | 08/21/2012
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Last Update Date | 09/06/2012
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Provider Practice Location Address
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Address Line | 2717 YORK AVE
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City | MCALLEN
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State | TX
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Zip | 78504-2185
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Country | US
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Telephone | 909-645-3066
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Fax |
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Provider Business Mailing Address
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Address Line | 2717 YORK AVE
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City | MCALLEN
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State | TX
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Zip | 78504
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Country | US
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Telephone | 909-645-3066
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JEROME MENDIOLA OCAMPO
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Credential | DDS
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Telephone | 909-645-3066
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 26106
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License Number State | TX
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