Provider Demographics
NPI:1811366115
Name:METRO DENTAL OF OCALA
Entity Type:Organization
Organization Name:METRO DENTAL OF OCALA
Other - Org Name:NORTH OCALA DENTISTRY
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DOCTOR OF DENTAL MEDICINE
Authorized Official - Prefix:
Authorized Official - First Name:TUQUYEN
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-368-2088
Mailing Address - Street 1:1325 NE 42ND STREET
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34479
Mailing Address - Country:US
Mailing Address - Phone:352-368-2088
Mailing Address - Fax:352-368-2806
Practice Address - Street 1:1325 NE 42ND STREET
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34479
Practice Address - Country:US
Practice Address - Phone:352-368-2088
Practice Address - Fax:352-368-2806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-17
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN180821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty