Provider Demographics
NPI:1184978819
Name:DENTAL TEAM OF OCALA, PA
Entity type:Organization
Organization Name:DENTAL TEAM OF OCALA, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIO
Authorized Official - Middle Name:
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:352-840-7077
Mailing Address - Street 1:2609 SW 33RD ST STE 104
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-7775
Mailing Address - Country:US
Mailing Address - Phone:352-512-0733
Mailing Address - Fax:
Practice Address - Street 1:8750 SW HIGHWAY 200 STE 101
Practice Address - Street 2:
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:2012-11-02
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN15063122300000X
FLDN15287122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty