Provider Demographics
NPI:1699221838
Name:UNIVERSITY OF FLORIDA COLLEGE OF DENTISTRY
Entity Type:Organization
Organization Name:UNIVERSITY OF FLORIDA COLLEGE OF DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL ASSISTANT PROFESSOR
Authorized Official - Prefix:
Authorized Official - First Name:ANA PAULA
Authorized Official - Middle Name:DIAS
Authorized Official - Last Name:RIBEIRO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MD, PHD
Authorized Official - Phone:352-575-3226
Mailing Address - Street 1:1395 CENTER DRIVE
Mailing Address - Street 2:ROOM D 9-6
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606
Mailing Address - Country:US
Mailing Address - Phone:352-294-8285
Mailing Address - Fax:
Practice Address - Street 1:1395 CENTER DRIVE
Practice Address - Street 2:ROOM D 9-6
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606
Practice Address - Country:US
Practice Address - Phone:352-294-8285
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-28
Last Update Date:2016-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDTP639261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental