Provider Demographics
NPI:1952849952
Name:FERNANDEZ AND SANCHEZ DDS, PA
Entity Type:Organization
Organization Name:FERNANDEZ AND SANCHEZ DDS, PA
Other - Org Name:DENTAL TEAM AT HEATHBROOK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JULIO
Authorized Official - Middle Name:
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:352-854-6563
Mailing Address - Street 1:5400 SW COLLEGE RD
Mailing Address - Street 2:SUITE 307
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-5756
Mailing Address - Country:US
Mailing Address - Phone:352-854-6563
Mailing Address - Fax:
Practice Address - Street 1:8750 SW HIGHWAY 200
Practice Address - Street 2:SUITE 101
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34481-7810
Practice Address - Country:US
Practice Address - Phone:352-840-7077
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-09
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN15063122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty