Provider Demographics
NPI:1518477686
Name:TKV DENTAL
Entity Type:Organization
Organization Name:TKV DENTAL
Other - Org Name:TRUECARE FAMILY AND IMPLANT DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INSURANCE CERDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:SYLVIA
Authorized Official - Middle Name:LOCKLAIR
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-431-2208
Mailing Address - Street 1:9401 SW SR 200
Mailing Address - Street 2:SUITE 101
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34481
Mailing Address - Country:US
Mailing Address - Phone:813-782-2312
Mailing Address - Fax:
Practice Address - Street 1:9401 SW SR 200
Practice Address - Street 2:SUITE 101
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34481
Practice Address - Country:US
Practice Address - Phone:813-782-2312
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TKV DENTAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-10-03
Last Update Date:2017-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL17033122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty